TOP 56 - Parental Perspectives on Prenatal Consults in a Level IV neonatal intensive care unit (NICU)

Publication Number: 4760.TOP 56

Prithvi Mohan, The Mount Sinai Kravis Children's Hospital, New York, NY, United States; Katherine Guttmann, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Andrea Weintraub, Icahn School of Medicine at Mount Sinai, New, NY, United States; Elizabeth Mari, Icahn School of Medicine at Mount Sinai, Flushing, NY, United States

Background: Antenatal counseling for threatened preterm births is essential for information exchange between parents and physicians to enable shared decision-making. These conversations are challenging and require participation of both Maternal-Fetal Medicine physicians (MFMs) and Neonatologists (Neos) to succinctly communicate complex medical information and elicit parental values. While it is well established that parents value clear, compassionate, and individualized counseling, how parents experience these consults is not well described. Understanding the parental perspective is critical to improving antenatal counseling and targeted education for providers.

Objective: To (1) describe parental experiences of prenatal consults for periviable preterm births; (2) identify key domains of strength and opportunities for improvement prior to implementation of a structured communication education curriculum for MFMs and Neos. We hope that following completion of this study, we will better understand current practice and lay the groundwork for assessing the impact of an educational initiative.

Design/Methods: This qualitative interview study was deemed exempt by the Mount Sinai Hospital IRB. Parents of infants born between January 1 and September 30, 2025, at < 30 weeks gestation or < 1250 grams who received a prenatal consult from Maternal-Fetal Medicine (MFM) physicians and/or Neonatologists (Neos) were eligible. Enrollment continued until thematic saturation was reached. Interviews explored parental experiences of prenatal consults, focusing on communication clarity, consistency between MFM and Neo counseling, emotional support, alignment with parental values, and overall satisfaction. Both open-ended and Likert-scale questions were included. Semi-structured interviews were conducted in person or by phone and audio-recorded. Fourteen interviews were completed, reaching thematic saturation. Transcripts will be reviewed and analyzed thematically following Braun and Clarke’s framework. Two researchers (PM, KG) will independently code transcripts inductively to identify key themes. A third reviewer (AW) will assess coding consistency and identify missed concepts. Discrepancies will be resolved through consensus, and themes refined iteratively to ensure rigor. Findings will inform areas for improving communication between MFM and Neo teams. A subsequent phase will include interviews with parents after implementation of a communication education initiative to evaluate its impact on prenatal consult experiences.