Authors (including presenting author) :
Lam WK, Ng YHR, Lau HE, Kwok WY, Liong MT, Leung TK
Affiliation :
Department of Paediatrics, Queen Elizabeth Hospital
Keyword 1: :
Antenatal counselling
Keyword 2: :
Neonatal intensive care unit
Keyword 3: :
High-risk pregnancy
Keyword 4: :
Parental stress
Keyword 5: :
Family-centred care
Introduction :
Expectant mothers with high-risk pregnancies anticipating neonatal intensive care unit (NICU) admission experience significant anxiety during the antenatal period. Traditional crisis-mode counselling at admission often leaves families psychologically unprepared for the NICU experience. Recognising this gap, our unit established a proactive antenatal pre-admission counselling programme in 2014, offering comprehensive NICU preparation before delivery to facilitate psychological readiness and informed decision-making.
Objectives :
To evaluate the 10-year impact of the antenatal pre-admission counselling programme on maternal stress reduction, information adequacy, breastfeeding decision-making, and overall satisfaction among mothers with high-risk pregnancies.
Methodology :
A retrospective analysis of 332 questionnaires collected from 2014-2024 was conducted (response rate 51%). The programme provided expectant mothers with NICU ward introductions, environmental familiarisation through photographs, breastfeeding education, colostrum oral care information, kangaroo care guidance, and preterm case sharing. Following delivery and NICU admission, mothers voluntarily completed questionnaires retrospectively evaluating the antenatal counselling. Questionnaires assessed stress reduction (3-point scale), information usefulness (5-point Likert scale), adequacy, desire for ward visits, breastfeeding decision impact, and overall satisfaction (5-point scale). Qualitative comments were thematically analysed to capture parental perspectives.
Result & Outcome :
Data revealed significant positive outcomes: 85.3% of participants agreed the counselling reduced antenatal stress and anxiety. Breastfeeding information was rated most useful among all content areas. Remarkably, 89.2% reported the visit determined their breastfeeding decision, demonstrating substantial influence on infant feeding choices. Information adequacy was rated 95.7%, though parents requested more comprehensive content on preterm complications and diverse gestational age case examples. Environmental familiarisation emerged as a critical need, with 87% desiring actual ward visits. Qualitative analysis revealed the dominant theme “seeing is believing” - parents valued observing the physical environment and care practices for psychological preparation and trust-building. Overall satisfaction was notably high (mean: 4.50/5.0; 91% satisfied). Parents expressed genuine gratitude for the personalised counselling, with specific staff recognition highlighting the meaningful rapport established during this vulnerable period. This decade-long evaluation demonstrates that proactive antenatal pre-admission counselling effectively transforms anticipatory anxiety into informed partnership for high-risk pregnancies. The programme exemplifies people-centred care by addressing psychological needs before crisis, professional service through sustained evidence-based delivery, committed staff through personalised support, and teamwork through antenatal-neonatal collaboration. This model offers a sustainable, replicable framework for family-centred neonatal care.
