More 'Extreme' Preemies Surviving

ByABC News
June 2, 2009, 6:02 PM

June 3 -- TUESDAY, June 2 (HealthDay News) -- Advances in the care of extremely premature infants mean that about 70 percent of these tiny newborns now survive their first year of life, Swedish researchers report.

The number of preterm births is increasing worldwide, and advances in perinatal medicine have increased survival. That means that neonatal intensive care can now be lifesaving even for the most premature infants -- those born between 22 and 26 weeks of gestation.

The news is important, the researchers said, because if parents and doctors believe a preemie's chances for survival are already slim, less aggressive care might be extended.

But the new results suggest that the evaluation of "extremely preterm babies should be done individually, considering both the survival chances and the morbidity risks," said Dr. Karel Marsal, a professor of obstetrics and gynecology at Lund University and the lead researcher.

"The survival rates of extremely preterm infants are high, even at the borders of viability," he noted.

The report is published in the June 3 issue of the Journal of the American Medical Association.

For the study, Marsal's group collected data on more than 305,000 infants born in Sweden from 2004 to 2007. Among these infants, 1,011 were born extremely preterm (before 27 weeks), including 707 born alive and 304 stillborn.

After one year, 70 percent of the 707 children were still alive, with dramatic increases in survival for each additional week of gestation. For babies born at 22 weeks, one-year survival was 9.8 percent; at 23 weeks it was 53 percent; at 24 weeks, survival was 67 percent; at 25 weeks it was 82 percent; and at 26 weeks, one-year survival reached 85 percent.

Among the surviving infants, 45 percent had no severe neonatal illness at 1 year old.

The overall perinatal death rate was 45 percent, ranging from 93 percent at 22 gestational weeks to 24 percent at 26 weeks, the study found. Among live births, 22 percent of the infants died within six days of delivery, including 8.2 percent who died in the delivery room and 5 percent died from seven to 27 days after birth.