Parental response to severe or lethal prenatal diagnosis: a systematic review of qualitative studies

TY - JOUR

T1 - Parental response to severe or lethal prenatal diagnosis

T2 - a systematic review of qualitative studies

AU - Lou, Stina

AU - Jensen, Lotte Groth

AU - Petersen, Olav Bjørn

AU - Vogel, Ida

AU - Hvidman, Lone

AU - Møller, Anne

AU - Nielsen, Camilla Palmhøj

N1 - © 2017 John Wiley & Sons, Ltd.

PY - 2017/8

Y1 - 2017/8

N2 - Objective: A severe or lethal prenatal diagnosis places great demands on prospective parents, who face choices of far-reaching consequences, such as continuing or terminating the pregnancy. How best to support these parents is a clinical challenge. This systematic review aimed to identify and synthesize the qualitative evidence regarding prospective parents' responses to such prenatal diagnoses. Methods: Following PRISMA guidelines, four databases were systematically searched and 28 studies met the inclusion criteria. Thematic analysis guided data extraction and synthesis of findings. The Confidence in the Evidence for Reviews of Qualitative research assessment tool was utilized to assess confidence in the findings. Results: Prospective parents experienced multiple losses, for example, of the healthy child, normal pregnancy and envisioned future. After diagnosis, they requested timely and reliable information and empathetic continued interaction with clinicians. Prospective parents who continued the pregnancy wished to be acknowledged as parents and engaged in planning to obtain a sense of meaning and control. Selective disclosure and concerns about negative responses were issues both for the parents who terminated and those who continued a pregnancy. Conclusion: Clinicians can support parental coping following a severe prenatal diagnosis through continued dialogue and collaboration. Further research is needed on the experiences of parents who choose to terminate a pregnancy following prenatal diagnosis.

AB - Objective: A severe or lethal prenatal diagnosis places great demands on prospective parents, who face choices of far-reaching consequences, such as continuing or terminating the pregnancy. How best to support these parents is a clinical challenge. This systematic review aimed to identify and synthesize the qualitative evidence regarding prospective parents' responses to such prenatal diagnoses. Methods: Following PRISMA guidelines, four databases were systematically searched and 28 studies met the inclusion criteria. Thematic analysis guided data extraction and synthesis of findings. The Confidence in the Evidence for Reviews of Qualitative research assessment tool was utilized to assess confidence in the findings. Results: Prospective parents experienced multiple losses, for example, of the healthy child, normal pregnancy and envisioned future. After diagnosis, they requested timely and reliable information and empathetic continued interaction with clinicians. Prospective parents who continued the pregnancy wished to be acknowledged as parents and engaged in planning to obtain a sense of meaning and control. Selective disclosure and concerns about negative responses were issues both for the parents who terminated and those who continued a pregnancy. Conclusion: Clinicians can support parental coping following a severe prenatal diagnosis through continued dialogue and collaboration. Further research is needed on the experiences of parents who choose to terminate a pregnancy following prenatal diagnosis.

KW - Congenital Abnormalities

KW - Humans

KW - Parents/psychology

KW - Prenatal Diagnosis/psychology

U2 - 10.1002/pd.5093

DO - 10.1002/pd.5093

M3 - Review

C2 - 28614902

SN - 0197-3851

VL - 37

SP - 731

EP - 743

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

IS - 8

ER -