Parental perceptions on the value of neonatal brain MRI: Brain, Development and Imaging

Abstract

Background: Brain MRI is often part of routine screening in extremely preterm infants (EPI, <28 weeks of gestation) to provide neurodevelopmental prognoses. Little research has been done on parental perceptions on routine MRI, while parents have to handle the results. This study aims to describe parental perceptions on the value and communication of routine MRI. Methods: Parents of 205 EPI who were admitted to the neonatal intensive care of the Wilhelmina Children’s Hospital between 2016 and 2021 were invited to complete an online survey on neonatal MRI. Data were analysed by frequency distributions and Fisher–Freeman–Halton exact tests to determine associations between different prognoses and responses about MRI. Bivariate analyses excluded parents who answered “do not remember”, causing different total numbers per analysis. Results: The analysis included parental responses of 85 EPI (41.5% response rate). 81% recalled being informed about the advantages of MRI, whereas only 44% recalled hearing about possible risks. 34.5% felt they had no choice regarding MRI and 37.3% were not asked whether they wanted to know the results. While the results were useful for 94.8% of parents and 63.2% reported that they reassured them about their child’s development, 74% did not think their child received adjusted treatment based on the results. However, all parents who received a worrisome prognosis (n = 5) reported that their child received adjusted treatment after MRI, opposing 7.7% (n = 26) of parents who received a good prognosis (p ≤ 0.001). For 66.7% of parents who received a worrisome prognosis (n = 6), the results caused anxiety about their child’s development, opposing no parents (n = 29) who received a good prognosis (p ≤ 0.001). Moreover, the poorer the prognosis, the more often parents reported that their child developed better than predicted (p ≤ 0.001). Conclusion: In this sample, parental perceptions on MRI are mainly positive. However, worrisome prognoses can cause parental anxiety, while these parents also reported their child to develop better than expected based on the prognosis. This suggests that such prognoses should be carefully discussed with parents. Additionally, communication can be improved by explaining both advantages and risks, and by presenting MRI as shared decision-making, with an important voice of parents.