More babies born at 22 weeks of gestation survive with help

Babies born as early as 22 weeks are surviving in greater numbers with medical intervention, according to a new study that could impact the abortion debate. The age of viability when a baby can survive outside the womb is generally accepted as 24 weeks of gestation. The earliest-reported surviving premature baby—who will celebrate his 28th birthday next week—was born at 21 weeks and 5 days.

A study published last week in the New England Journal of Medicine followed about 5,000 infants born between 2006 and 2011 at 27 weeks of gestation or earlier. The purpose of the study was to examine treatment of “extremely preterm infants” at two dozen hospitals, all of which belong to the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. The institute’s director is Alan E. Guttmacher, nephew of past Planned Parenthood president Alan F. Guttmacher.

Guidelines in the United States and Canada call for intensive medical intervention for infants born at 25 weeks or later, but only palliative care if the baby is 22 weeks or younger. An individual assessment based on the baby’s medical status and the parents’ wishes is recommended for babies born at 23 or 24 weeks.

The rate of active treatment, defined as “potentially lifesaving intervention administered after birth,” at the hospitals in the study was only 22.1 percent for babies born at 22 weeks. In other words, doctors attempted to save just two out of every nine babies born at 22 weeks. Some of the hospitals followed an aggressive treatment strategy, while others offered no active treatment. Nearly 100 percent of the babies born at or after 26 weeks received active treatment, and 81 percent of those children survived.

Of the 78 cases in the study where 22-week babies received active treatment, only 18 babies (23 percent) survived, but one-third of them had serious problems like blindness or cerebral palsy. Still, that number is a slight improvement over the 20 percent survival rate of mechanically ventilated, 22-week babies in a 2008 New England Journal of Medicine report. Specialists in the field estimate survivability of premature babies over the past 40 years has increased by about one week per decade.

Dr. Edward Bell, a co-author of the study, told The New York Times he considers 22 weeks a new threshold of viability. “I guess we would say that these babies deserve a chance,” he said.

The study may propel pro-life groups to push for changes in abortion laws and neonatal care policies. Currently, 21 states prohibit abortion after viability, and seven other states ban abortion after 24 weeks of gestation. Many of these states make exceptions for the mother’s life or other reasons. Almost 99 percent of abortions are carried out on babies before they reach 20 weeks, according to the Guttmacher Institute.