393 - The Use of a Visual Aid to Guide Prenatal Consultation on Extreme Prematurity

Publication Number: 393.6876

Ashley Olszewski, University of Kentucky College of Medicine, Lexington, KY, United States; Courtney L. Kantzler, University of Kentucky, Lexington, KY, United States; Prasad Bhandary, University of Kentucky, Lexington, KY, United States; Aparna Patra, Pediatrix Neonatology of Fort Worth, Texas, Fort Worth, TX, United States

Background: Prenatal counseling on extreme prematurity can be challenging as it involves the explanation of complex medical terminology. Mothers may find it difficult to understand the topics discussed, and many report that they were not well informed of the complications of extreme prematurity and were not prepared for the appearance of their extremely low birth weight (ELBW) infant at birth. This often results in increased maternal stress. Visual aids can improve retention of information, reduce anxiety, and enhance understanding. However, there is little data showing the effectiveness of visual aids when used for prenatal consultation on extreme prematurity.

Objective: Our objective was to compare maternal understanding of the complications of extreme prematurity with and without the use of a visual aid during prenatal consultation with the neonatology team.

Design/Methods: Women at risk of delivery before 30 weeks’ gestation were surveyed immediately following their prenatal consultation with the neonatology team. The questionnaire used a 10-point Likert scale to assess their understanding of the topics discussed. Based on the survey feedback, we developed a visual aid depicting the size and appearance of an ELBW infant, the equipment used in the neonatal intensive care unit (NICU), the short- and long-term complications of extreme prematurity, the importance of mother’s own milk, and how parents are involved in caring for their babies in the NICU. The survey was then given to a separate group of mothers after prenatal consultation that included the visual aid. Survey responses between groups were compared to assess the effectiveness of the visual aid.

Results: A total of 31 mothers completed the survey, of which 14 were consulted using the visual aid. There were no differences in maternal age, race, ethnicity, or paternal involvement between groups. The median gestational age at the time of consultation was 24+6 weeks’ gestation and similar between groups. We found that mothers who were consulted using the visual aid were significantly more likely to strongly agree that they felt prepared for the appearance of their baby after birth (median 5 vs 10, p< 0.05). They were also more likely to strongly agree that they understood the complications of extreme prematurity and the chances of survival (median 8 vs 10, p=0.04) following consultation.

Conclusion(s): The use of a visual aid during prenatal consultation can improve maternal preparedness for the appearance of the ELBW infant at birth and her understanding of the chances of survival and the complications following an extremely premature birth.