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Bereavement support effectiveness for parents of infants and children: a systematic review
  1. Tom Ainscough1,
  2. Lorna Fraser1,
  3. Joanna Taylor1,
  4. Bryony Beresford2 and
  5. Alison Booth1
  1. 1 Department of Health Sciences, University of York, York, UK
  2. 2 Social Policy Research Unit, University of York, York, UK
  1. Correspondence to Dr Lorna Fraser, Department of Health Sciences, University of York, York YO10 5DD, UK; lorna.fraser{at}


Objectives This systematic review aims to assess the effectiveness of bereavement support interventions (BSIs) for parents of an infant or a child who has died from a medical condition or in unforeseen circumstances.

Methods A systematic search of MEDLINE, PsycINFO, Embase and CINAHL (1980 to January 2018) was performed to identify studies investigating BSIs for the parents of children who died between the ages of 24 weeks gestation and 30 years. Due to significant clinical and methodological heterogeneity between studies, a narrative synthesis was performed.

Results The database searches returned 24 550 records, with a further 6 identified through other sources. Of these, eight studies, reported in nine papers, met the inclusion criteria. Most studies were conducted in the USA (n=5) and in perinatal/neonatal deaths (n=6). Five of the included studies were randomised controlled trials and three were non-randomised comparative studies. Interventions were delivered to groups, individuals or families. Outcomes of interest were grief, mental health, physical health and ‘others’. There were major concerns over the quality of study methods and reporting. Only three of the nine studies reported a significant difference between experimental and control arm participants in any outcomes, despite a total of 23 outcomes being measured.

Conclusions Poor methodology and reporting of the few studies which have assessed BSIs for parents limit any conclusions on their effectiveness. Agreement on core outcomes and more robust study methodology are required in this neglected area of research.

  • bereavement
  • grief
  • child death
  • neonates

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors The idea was conceived by LF, AB and BB. Analyses was undertaken by TA, JT, AB, BB and LF. The final manuscript was approved by all authors.

  • Funding This article presents independent research funded in partnership between the University of York and Martin House Hospice Care for Children and Young People, West Yorkshire, England.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of either the University of York or Martin House Hospice Care for Children and Young People.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.