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Incidence of severe disability among very premature babies has not changed for a decade

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8264 (Published 04 December 2012) Cite this as: BMJ 2012;345:e8264
  1. Zosia Kmietowicz
  1. 1BMJ

More babies born between 22 and 25 weeks of gestation in England survived in 2006 than in 1995, research shows.

However, survival has improved only among those babies born at 24 and 25 weeks. Babies born at 23 weeks’ gestation were no more likely to survive in 2006 than they were in 1995, despite advances in care. The current legal limit for abortion is 24 weeks.

The research also found that about a fifth of babies (19%) born between 22 and 25 weeks’ gestation in 2006 had a severe disability, a figure that has remained unchanged since 1995.

The findings are from two studies in the BMJ that followed two cohorts of very premature babies born 11 years apart, one group from 1995 and another from 2006.

The first study, which looked at outcomes among babies until they were discharged from hospital, found that the number of babies born at 22 to 25 weeks’ gestation who were admitted to neonatal care rose by 44% over the 10 years, from 666 in 1995 to 1115 in 2006.1 More than half these babies (53%) survived in 2006, up from 40% in 1995.

The researchers were not sure what may have caused the increase in premature births, although older mothers and ethnicity are possible risk factors. However, improvements in survival seem to be a result of better care in the first week of life, especially keeping babies warm, reducing infections, and better transportation to specialist units, as well as use of steroids and surfactant treatment.

The second study looked at babies’ development to the age of 3 years.2 It found a relation between gestation and the risk of disability. In 2006 a fifth of preterm babies born at 26 weeks’ gestation had a severe disability at three years, whereas the proportion was 45% in those born at 23 weeks.

The study also showed that the proportion of babies born at 24 and 25 weeks who were free of disability rose from 23% in 1996 to 34% in 2006.

Because more babies were surviving with severe disabilities such as severe cerebral palsy, blindness, and deafness, pressure on health, education, and social care services would increase, said Neil Marlow, a Medical Research Council funded researcher at University College London’s Institute for Women’s Health and one of the study’s authors.

Another author, Kate Costeloe, from Queen Mary College, University of London, and Homerton University Hospital, said, “This research shows that while we still have some way to go in improving the outlook for extremely premature babies, we’re definitely moving in the right direction. The similarities between two sets of children born 11 years apart also indicate that continuing to follow the older children as they grow will give us important information about the outlook for premature babies born today and in the future. This will help to ensure these babies get the best possible care at birth and throughout their development.”

Notes

Cite this as: BMJ 2012;345:e8264

Footnotes

  • bmj.com Briefing: Is abortion worldwide becoming more restrictive? (BMJ 2012;345:e8161, doi:10.1136/bmj.e8161)

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