It was never easy, but trying to decide whether to save extremely premature babies just got harder.
A study called EPICure compared the fates of babies born 22 to 26 weeks into pregnancy in the UK in 1995 with similar babies born in 2006. In this 11-year period, the babies surviving their first week rose from 40 to 53 per cent. But an accompanying study comparing the fate of survivors at age 3 found that the proportion developing severe disabilities was unchanged, at just under 1 in 5.
"We've increased survival, but it's confined to the first week of life," says Kate Costeloe of Queen Mary, University of London, author of the first study. "Yet the pattern of death and health problems is strikingly similar between the two periods."
The absolute numbers of premature babies born over the 11 year period increased by 44 per cent, from 666 in 1995 to 959 in 2006. This meant that the absolute numbers of children with severe disabilities such as blindness, deafness or lameness also rose, increasing the burden on health, educational and social services.
Lifelong disability
"As the number of children that survive preterm birth continues to rise, so will the number who experience disability throughout their lives," says Neil Marlow of University College London, who led the second study.
By far the worst outcomes were for the youngest babies, with 45 per cent of those born at 22 or 23 weeks in 2006 developing disabilities compared with 20 per cent of those born at 26 weeks. In 1995 only two babies survived after being born at 22 weeks. In 2006, three did.
In 2006, a panel of UK ethicists concluded that babies born at 22 weeks should be allowed to die, as with babies born at or before 23 weeks in France and Holland.
Journal references: BMJ, Costeloe et al, DOI: 10.1136/bmj.e7976; Marlow et al, DOI: 10.1136/bmj.e7961
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When is a baby too premature to save?
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When is a baby too premature to save?
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When is a baby too premature to save?
