One major ethical issue is to determine whether babies born very prematurely should be kept alive using life support techniques when there is a possibility that, if they survive, they could have significant neurological problems. In order to evaluate this, the clinical outcome of babies born before 27 weeks or between 22 and 25 weeks’ gestation were followed up in various English hospitals for three years. The first group included 1031 children and the second 584.
Of 576 babies born in 2006, 13.4% (77) had severe complications and 11.8% (68), moderate. Cerebral palsy was detected in 83% (14) of survivors.
Comparing the results of those born after 2006 with those born after 1995, 18% of the survivors born between 22 and 25 weeks’ gestation in 1995 and 19% of those born after 2006 had major neurological problems.
The survival of babies admitted to neonatal intensive care units was 39% in 1995 and 52% in 2006; the survival without any medical complications was 23% in 1995 and 34% in 2006.
The authors of the study concluded that “a higher proportion of babies admitted for neonatal care now survive without disability, particularly those born at gestational ages 24 and 25 weeks” (BMJ 2012; 345: e7961 doi: 10.1136/bmj.e 7961, published 4 December 2012).
Given the important ethical questions that arise with the medical care that must be given to premature babies, we believe that the conclusions of this study, which showed high survival of many of these children without any medical issues, are extremely important.