Just because an infant is extremely premature, it doesn't mean he or she can't survive. That's according to new New England Journal of Medicine study from University of Iowa researchers, which suggests some babies as young as 22 weeks premature are viable.
Researchers complied data from thousands premature births at 24 academic hospitals nationwide. The mortality rate for babies under 1000 grams birth weight, bit over 2 lbs, was as high as 50 percent in hospitals, and as low as 10 percent in others.
The big difference was whether hospitals treated babies younger than 22 weeks with life-saving intensive care, as opposed to comfort care. Treatment these infants is controversial since the risks of death or life-long health problems are very high.
"We have to guard against the self-fulfilling prophecy," says Dr. Edward Bell, a pediatrician at the University of Iowa Hospitals and Clinics. "If those doctors say that, '22-week babies all die, and so we’re not going to offer treatment," we have to ask, 'Is the reason that they all die is because they’ve not been offered treatment?'”
Many parents of extremely preterm infants are advised that their child is not viable. But when parents are given odds of survival, Bell says often the statistics include babies who only received comfort care.
"I'm not willing to say that all these babies should be actively treated," Bell says. "We have to realize too that what's possible in Iowa or in the U.S. is not possible in other countries. We can't apply the results of this research around the world. So we've very fortunate that we have the ability to do things like this."
When a baby is premature physicians try to replace the biological elements of pregnancy. An infant is placed in an incubator with feeding and breathing tubes, and receives medication to aid organ development and circulation.
In addition to gestational age, a number of factors contribute a hospital's mortality rate for premature babies. Hospital resources, whether the infant is a multiple, and if the mother received steroid shots before giving birth are also factors.