Parental perspectives about information and deferred versus two-stage consent in studies of neonatal asphyxia

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Christian A. Maiwald - , University of Tübingen (Author)
  • Charlotte Rovers - , University of Tübingen (Author)
  • Annie Janvier - , University of Montreal (Author)
  • Heidrun Sturm - , University of Tübingen (Author)
  • Martina Michaelis - , University of Tübingen (Author)
  • Georg Marckmann - , Ludwig Maximilian University of Munich (Author)
  • Hans Joerg Ehni - , University of Tübingen (Author)
  • Christian F. Poets - , University of Tübingen (Author)
  • Mario Rüdiger - , Department of Paediatrics, Center for feto/neonatal Health (Author)
  • Axel R. Franz - , University of Tübingen (Author)

Abstract

Objective: The ALBINO Trial (NCT03162653) investigates effects of very early postnatal allopurinol on neurocognitive outcome following perinatal asphyxia where prenatal informed consent (IC) is impossible. Ethically and legally, waiver of consent and/or deferred consent (DC) is acceptable in such an emergency. Short oral/two-step consent (SOC, brief information and oral consent followed by IC) has recently been investigated. Methods: Mixed-methods analysis of parental opinions on DC versus SOC in the context of neonatal asphyxia in a survey at two German centres. Prospective parents (ProP), parents of healthy newborns (PNeo) and parents of asphyxiated infants (PAx) born between 2006 and 2016 were invited. Results: 108 of 422 parents participated (ProP:43; PNeo:35; PAx:30). Most parents trusted physicians, wanted preinterventional information and agreed that in emergencies interventions should begin immediately. Intergroup and intragroup variability existed for questions about DC and SOC. In the ALBINO Trial situation, 55% preferred SOC, and 26% reported DC without information might adversely affect their trust. Only 3% reported to potentially take legal action after DC. PAx were significantly more likely to support DC. PAx more frequently expressed positive emotions and appreciation for neonatal research. In open-ended questions, parents gave many constructive recommendations. Conclusion: In this survey, parents expressed diverse opinions on consent, but the majority preferred SOC over DC. Parents who had experienced emergency admission of their asphyxiated neonates were more trusting. Obtaining parental perspectives is essential when designing studies, while being cognisant that these groups of parents may not represent the opinion of all parents.

Details

Original languageEnglish
Pages (from-to)F106-F111
Number of pages6
Journal Archives of disease in childhood : the journal of the Royal College of Paediatrics and Child Health. Fetal & neonatal
Volume109
Issue number1
Early online date15 Dec 2023
Publication statusPublished - 1 Jan 2024
Peer-reviewedYes

External IDs

PubMed 37648417

Keywords

Keywords

  • Ethics, Neonatology, Parents/psychology, Prospective Studies, Parental Consent, Humans, Asphyxia Neonatorum/therapy, Infant, Asphyxia, Pregnancy, Female, Infant, Newborn, Informed Consent/psychology

Library keywords