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Research Letter
April 20, 2020

Effect of Neonatal Outcome Estimates on Decision-Making Preferences of Mothers Facing Preterm Birth: A Randomized Clinical Trial

Author Affiliations
  • 1Center for Pediatric and Adolescent Medicine, Department of Neonatology, Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  • 2Center for Pediatrics, Department of Neonatology, Medical Center–University of Freiburg, Freiburg im Breisgau, Germany
  • 3Center for Health Care Ethics, Hannover, Germany
  • 4Institute for the History, Philosophy, and Ethics of Medicine, Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  • 5Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  • 6Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
JAMA Pediatr. Published online April 20, 2020. doi:10.1001/jamapediatrics.2020.0235

Extremely preterm infants born before a gestational age (GA) of 25 weeks are in a prognostic gray zone,1 which means that outcomes are poor but not hopeless and that life-sustaining treatments are not obligatory. Treatment decisions are value-laden and challenging2 and ought to be shared between parents and physicians while imperatively aligned with parental preferences.3,4 When counseling parents, physicians commonly present numerical outcome estimates5 and may assume that parents derive their preferences from them. However, it is unknown whether probabilistic data affect parents’ choices in prognostic gray zones.6 Here, we hypothesized that better or worse neonatal outcome estimates do not affect expectant mothers’ preferences for life-sustaining treatments.

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