Normal gestation is 37 to 42 weeks. The earliest a baby can be born and still have a chance of surviving is generally 22 weeks. By 25 weeks, a baby’s chances of surviving and going on to lead a normal life are considered to be significantly better.
Research conducted by Gregory P. Moore, MD, of the Ottawa Hospital in Ontario, Canada, and his colleagues examined data from nine previous studies conducted after 2004 to determine how surviving preemies born between 22 and 25 weeks of gestational age were doing at 4 to 8 years of age. Most of the studies were conducted in Europe and included 900 children.
Study results showed:
- Among babies born at 22 weeks, 43 percent were impaired.
- For babies born at 23 weeks, 40 percent were impaired.
- Babies born at 24 weeks had a 28 percent impairment rate.
- Among babies born at 25 weeks, 24 percent were impaired.
As reported by Reuters Health, children scoring in the lowest 2 to 3 percent on IQ tests, children with cerebral palsy and those who were fully or mostly deaf or blind were included in the moderately to severely impaired category.
It is important to note, however, that the picture is not entirely bleak and that over half the preterm children in the study did not develop moderate to severe impairments.
Study author Moore acknowledged that the findings were limited by the small number of children born at the earliest gestations included in the investigation.
“We don’t want these [data] to make a physician automatically say, ‘There’s no hope’ or ‘There’s no chance,’” he told Reuters Health.
A heartbreaking decision for parents
Henry C. Lee, MD, assistant professor, Division of Neonatal & Developmental Medicine at Stanford University and Lucile Packard Children’s Hospital in California, sees the study as a way to help counsel families of extremely premature infants.
“It’s hopefully an informed decision that the family makes in terms of how they’re going to proceed, whether to try to provide very aggressive, intensive care to these infants or potentially to provide palliative and comfort care,” he told Reuters Health.
“The hard part too is there is still uncertainty,” he added. “Even though there is this risk, there are some infants at each of these gestational ages that will survive and not have disability.”
In a Cape Breton Post article, Moore recognized that having these types of discussions – putting a child’s odds into number – is “very difficult.”
“But some parents really do want to hear them. …They are afraid. There’s anxiousness. And we are doing our best to support them with accurate information that they want to hear – if they want to hear it.”