Evaluating professional guidelines for the care of dying previable infants

Objective. To identify, describe and evaluate published professional guidelines for the care of dying previable babies. Design. Systematic review and a search of databases including PubMed, MEDLINE and the Cochrane Library. Setting and sources. Publicly available, English language guidelines for the care of dying previable babies identified through a systematic literature search. Analysis. Applying the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration instrument to six guidlines for the treatment of previable babies. Results.The analysis demonstrated that the process of guideline development was not carried out in line with best practice as recommended by the National Institute for Health and Clinical Excellence (2007). The lack of an evidence base for care was not indicated in the guidelines. Conclusions. Current guidelines for the care of dying previable babies appear to be based on description and opinion, rather than evidence. Future guideline developments for this group of vulnerable babies and their families should follow a more transparent and systematic process to enable health professionals to deliver effective care.