Video Education in Early Pregnancy and Parent Knowledge of Neonatal Resuscitation Options

This secondary analysis of a randomized clinical trial investigates the proportion of correct answers on neonatal resuscitation options among parents after seeing a video on these options.


Introduction
For infants born during the periviable period of gestation, the decision to provide delivery room resuscitation is based on parental preference. 1 Even when preterm birth risk factors (eg, chronic hypertension) are identified in early pregnancy, most parents are first offered information on neonatal resuscitation options upon periviable delivery hospitalization, 2 when time constraints and stress limit contemplation.In the randomized clinical trial (RCT) of the smartphone Preemie Prep for Parents (P3) program, 3 we provided neonatal resuscitation education in early pregnancy and evaluated the association of the program with knowledge at 25 weeks' gestational age (GA).

Methods
The Medical College of Wisconsin institutional review board approved this secondary analysis of an RCT, which followed CONSORT reporting guidelines (ClinicalTrials.govIdentifier: NCT04093492) (see trial protocol in Supplement 1).Pregnant patients with preterm birth risk factors were recruited from the high-risk obstetric clinic between February 2020 and April 2021 and randomized 1:1.The randomization sequence was generated using R statistical software version 3.6.0(R Project for Statistical Computing) package blockrand and implemented through research electronic data capture (REDCap).Participants in P3 received text-messages with links to short, animated videos.
Participants in the control group received patient education web pages from the American College of Obstetricians and Gynecologists.Participating partners were assigned to the same study group as the pregnant patient.Starting at 21 weeks' GA, participants in P3 received 7 videos on neonatal resuscitation decisions (eg, Video; eTable in Supplement 2).At 25 weeks' GA, assessments on neonatal resuscitation knowledge were collected via REDCap.Outcome assessors were blinded to study group.The trial ended when the predetermined sample size was reached. 3 this post hoc, intention-to-treat analysis, the proportion of participants correctly answering each of 3 resuscitation questions was calculated in each study group.The difference in proportions is presented with the 95% CI.
Of 94 participants in the P3 group, 87 individuals (92.6%) watched 1 or more of 7 resuscitation videos.There were 79 participants in the control group.Participants in the P3 group were more likely to know the parental role in resuscitation decisions, lower and upper GA limits when parents are asked to make resuscitation decisions, and all 3 neonatal resuscitation options available at our institution (Figure).For example, 55.6% of participants in the P3 group correctly identified all 3 resuscitation options compared with 4.1% of participants in the control group.

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Open Access.This is an open access article distributed under the terms of the CC-BY License.b The correct responses were medical machines, comfort care, and limited use of medical machines.

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c The correct response was false.

Figure
Figure.Participant Correct Answers on Knowledge Questions DiscussionP3 is a novel prenatal program that provides neonatal resuscitation education in early pregnancy to parents with preterm birth risk factors.In this secondary analysis of an RCT, most parents watched at least 1 video and video use increased parental knowledge.
Open. 2023;6(11):e2344645. doi:10.1001/jamanetworkopen.2023.44645(Reprinted) November 27, 2023 1/4 Downloaded from jamanetwork.comby guest on 12/24/2023 Race and ethnicity were self-reported by participants selecting among National Institutes of Healthspecified racial and ethnic categories.Race options included American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, White, and other.Ethnicity options included Hispanic or Latino and not Hispanic or Latino.Race and ethnicity were reported because of past work demonstrating differences in neonatal intensive care at periviability by race and ethnicity. b