• Ninke M Schrijvers, Rosa Geurtzen, Draaisma Jos M T JMT Radboudumc Amalia Children's Hospital, Nijmegen, the Netherlands., Louis P Halamek, Nicole K Yamada, and Marije Hogeveen.
• Radboudumc Amalia Children's Hospital, Nijmegen, the Netherlands.
• Acta Paediatr. 2018 Oct 1; 107 (10): 1710-1715.

AimAmerican guidelines suggest that neonatal resuscitation be considered at 23 weeks of gestation, one week earlier than in the Netherlands, but how counselling practices differ at the threshold of viability is unknown. This pilot study compared prenatal periviability counselling in the two countries.MethodsIn 2013, a cross-sectional survey was sent to 121 Dutch neonatologists as part of a nationwide evaluation of prenatal counselling. In this pilot study, the same survey was sent to a convenience sample of 31 American neonatologists in 2014. The results were used to compare the organisation, content and decision-making processes in prenatal counselling at 24 weeks of gestation between the two countries.ResultsThe survey was completed by 17 (55%) American and 77 (64%) Dutch neonatologists. American neonatologists preferred to meet with parents more frequently, for longer periods of time, and to discuss more intensive care topics, including long-term complications, than Dutch neonatologists. Neonatologists from both countries preferred shared decision-making when deciding whether to initiate intensive care.ConclusionNeonatologists in the United States and the Netherlands differed in their approach to prenatal counselling at 24 weeks of gestation. Cross-cultural differences may play a role.©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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