Children born prematurely today are more likely to survive and have no neurodevelopmental impairment than in the past, according to a study.
Researchers said this suggests that fewer pre-term children need treatment at an early age.
Children who survive a premature birth are at risk of developing cerebral palsy, blindness, hearing loss, and intellectual impairment.
The study, “Survival And Neurodevelopmental Outcomes Among Periviable Infants,” was published in the New England Journal of Medicine.
Survival rates of children born prematurely have increased in the past five years. But less has been known about whether they were healthy or had neurodevelopmental impairment.
Researchers analyzed survival and neurodevelopmental outcomes among 4,274 infants born at 22 to 24 weeks of pregnancy. The study covered children at 11 centers in three time periods: 2000–2003 (epoch 1), 2004–2007 (epoch 2), and 2008–2011 (epoch 3).
They considered three outcomes: survival without neurodevelopmental anomalies, survival with neurodevelopmental anomalies, and death.
Infants’ survival rates increased from 30 percent in epoch 1 to 36 percent in epoch 3. These percentage surviving with no neurodevelopmental anomalies increased from 16 percent in epoch 1 to 20 percent in epoch 3. The percentage who developed neurodevelopmental anomalies did not change significantly — 15 percent in epoch 1 and 16 percent in epoch 3.
The survival rates of both children with and without neurodevelopmental impairment were considerably higher from epoch 1 to epoch 3. The rate for children with impairment in epoch 3 was 1.59 times higher than in epoch 1. For children without impairment, it was 1.27 times higher.
“Our study provides important information for physicians and family members planning the care of these extremely fragile newborns,” Rosemary Higgins, MD, the author of the study, said in a news release.
Although the study included a large number of infants from multiple centers, Higgins cautioned that the results should not be used to predict a child’s survival.
“Every individual is different, and no single source of information can precisely predict a baby’s chances of survival or disability,” she said. “But our study’s findings do provide important information that physicians and family members can consult to help determine treatment strategies.”
Researchers believe the survival improvement and reduced probability of neurological damage are a result of better care given to mothers and newborns. This may include an increase in the use of antenatal steroids. They are given to mothers at risk of a premature birth to help the infant’s lungs mature, reducing the likeliness of a newborn needing help to breathe.