463 - Parents’ Experiences and Acceptance of In-Bed Resuscitation at Birth: An Implementation Survey within the SAVE Randomized Controlled Trial

Publication Number: 1445.463

Katarina Ekelöf, Lund University, Halmstad, Hallands Lan, Sweden; Maria Wilander, Lund University, Halmstad, Hallands Lan, Sweden; Anna HE. Santesson, University of lLund, Halmstad, Hallands Lan, Sweden; Ola Andersson, Lund University, Halmstad, Hallands Lan, Sweden; Li Thies-Lagergren, Lund University, Lund, Skane Lan, Sweden

Background: Evidence supporting parental presence during neonatal resuscitation is increasing, yet parents commonly fear separation from their infant during emergency procedures. In-bed intact cord resuscitation (ICR) offers potential benefits including maintained placental circulation and family-centered care. However, successful implementation of new neonatal resuscitation approaches requires not only evidence of clinical efficacy but also attention to parental perspectives and acceptance, which are key to the sustainable integration of ICR into routine practice.

Objective: To evaluate parental experiences and acceptance of in-bed neonatal resuscitation compared to standard resuscitation measures at birth.

Design/Methods: Parents of neonates randomized to in-bed intact cord resuscitation (ICR) or standard resuscitation in the SAVE study received an electronic survey approximately one month after birth. The survey assessed parental experiences and acceptance using questions with 5-point Likert scale responses to explore differences in perceptions of safety, contact, and communication during resuscitation. Data were analyzed in descriptive and comparative analyses. For questions without a neutral midpoint, all response options were included in the analyses. For questions with a neutral midpoint, responses were dichotomized by excluding middle categories, keeping only extreme options for comparison. Group differences were evaluated using Chi-square tests and odds ratios. P-value < 0.05 were considered significant.

Results: Of 333 respondents (73.4% response rate), 303 were mothers (91.0%) with mean age 31.9 years (SD 4.3). No significant demographic or obstetrical differences existed between groups. Parents experiencing in-bed ICR reported a significantly higher proportion of positive responses (strongly positive or positive) regarding study participation, with 127 (83.6%) compared to 116 (65.9%) in the control group, p = 0.009. Significantly greater positive odds ratios for parental perceptions of safety, seeing and touching their child, were observed in the in-bed ICR group compared to controls (Table 1). The descriptive distribution of responses for these outcomes and for communication with staff is illustrated in Figure 1.

Conclusion(s): In-bed ICR demonstrated high parental acceptability with significantly improved satisfaction regarding study participation and perceived neonatal benefit. These findings support the feasibility and acceptability of implementing in-bed ICR in clinical settings while maintaining effective healthcare communication.

Distribution of Parental Responses regarding Safety, Contact, and Communication during Neonatal Resuscitation
Each question (left axis) is shown with two clustered stacked bars representing responses in the intervention (In-Bed) and control groups. Each bar is divided into five segments corresponding to response options, with segment size indicating the proportion of parents selecting that option. Green shades indicate more positive responses, and orange shades indicate more negative responses.

Parents' sense of safety, contact with neonate, and communication with healthcare staff (n=333)
Data are presented as number and percentage (n, %) of dichotomized responses by study group, along with odds ratios (OR), 95% confidence intervals (CI), and p-values for group comparisons.