‘No rise’ in survival rates for very premature babies

There has been no rise in survival rates of babies born before 24 weeks of pregnancy in the past 12 years, a new study claims today.

Researchers from the University of Leicester say their findings suggest the limits of viability for the survival of premature babies have been reached.

The time span of 24 weeks is important as politicians are due to debate next week whether the limit for abortions should be lowered from 24 to 20 weeks.

Proponents of this reduction say it is needed as improvements in care mean more babies can survive if they are born between 20 and 24 weeks.

As such hospitals could be performing abortions on fetuses up to 24 weeks on one ward and trying to save the life of a premature baby of the same age on another ward.

The authors of today’s study analysed the survival rates of all babies born before 26 weeks’ gestation who were alive at the onset of labour in the Trent health region of the UK between 1994 and 1999 and 2000 and 2005.

This study involved 16 hospitals with over 55,000 births a year.

The findings, published in the British Medical Journal (BMJ), revealed that despite over half the babies born at 23 weeks being admitted to intensive care, there was no improvement in survival in this group over the 12 years of the study.

During this period care for the 150 babies born at 22 weeks remained unsuccessful, and none survived to discharge.

The study did find a significant improvement however in the number of more mature preterm infants born at 24 and 25 weeks who survive to discharge.

Of 497 babies admitted to intensive care in 2000 to 2005, 236 (47 per cent) survived to discharge compared with 174 of 490 (36 per cent) in 1994 to 1995.

“Our findings concur with the view? that the limit of viability had been reached,” the researchers conclude.

“Large improvements in the survival to discharge of admitted babies born at 24 and 25 weeks in the most recent time period suggests that a blanket policy of not resuscitating these infants is inappropriate.”

In an accompanying editorial Professor Neena Modi from Imperial College London said the findings are important given the coming parliamentary debate on abortion limits.

“When moral judgments are imposed on those holding different views and when the rights of the infant, be it to life or death, are in danger of colliding with those of parents and society the need for evidence is paramount,” she added.

Dr Tony Calland, chairman of the British Medical Association’s medical ethics committee, said the research adds further weight to the view that there is no scientific justification for lowering the 24-week abortion limit.

“Although the vast majority of abortions take place in the first trimester3 there are still women who need abortion services later on in their pregnancy,” he commented.

“This applies particularly to very young women or those close to the menopause who may not realise they are pregnant. To lower the abortion limit would leave a number of women in dire circumstances.”