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Some Very Premature Babies Can Survive With Aggressive Treatment, Report Finds


A new study shows that extremely premature babies born as early as 22 weeks can survive with aggressive treatment. The report was published today in the New England Journal of Medicine. NPR health correspondent Rob Stein joins us now to discuss these results. And, Rob, first, tell us about this study of extremely premature babies.

ROB STEIN, BYLINE: Well, researchers looked at almost 5,000 babies that were born at 24 hospitals around the country, and these were babies that were born between 22 and 27 weeks into a pregnancy. And just as a reminder, a full-term, normal pregnancy last 40 weeks, so these babies came really early. They were really tiny. Some weighed less than a pound.

SIEGEL: We're talking about babies born after six months - maybe some fewer than five months of pregnancy. What were the researchers trying to find out?

STEIN: They were trying to get an idea of how aggressively different hospitals treated these babies - whether some of them tried really hard to save them and whether others didn't try as hard and whether it made any difference. And the answer to both those questions was yes. There were big differences. Some hospitals tried really hard to save all these babies. Others didn't. And they found that it had a significant impact on what happened.

SIEGEL: How different were the results?

STEIN: Yeah, let's talk about the most premature babies, the babies that were 22 or 23 weeks into the pregnancies. And in that case, it made a significant difference. If the babies weren't treated, none of them survived. If the babies were treated aggressively by things like getting help breathing or special medicines to help their lungs, about a quarter of them survived.

SIEGEL: They survived, but did they survive in good condition and good health?

STEIN: Well, 18 of 79 of these babies survived, so you can see that it really only helped a small proportion of the babies, and of those who survived, only seven survived without some kind of significant complication. We're talking about something like blindness, deafness or cerebral palsy.

SIEGEL: So what impact do you think this study will have?

STEIN: Well, the researchers hope it'll do a couple things. One is to provide some hard data for doctors so they really know and understand what the possibilities are. There's a thinking that, you know, medical science has advanced a lot in the last 10 years, and a lot of doctors may not realize that trying can really help some of these babies if they attempt some of these new approaches that have become available - and that doctors right now don't really have a sense of whether this can be prolonging baby suffering, that it's going to be really expensive, or whether it can make a difference. And they're hoping that this will help doctors at least consider trying these treatments on some of these babies.

SIEGEL: But I'm trying to imagine being the parent of a newborn at 22 weeks and being told, we could try aggressively to keep the baby alive. The odds are 3 to 1 that the baby will not survive, and if the baby does survive, the majority of such babies have some severe condition as a result. Sounds like a pretty tough choice to confront a parent with.

STEIN: There's no question - absolutely. These are agonizing decisions to make, and these data, you know, explain that clearly - that yes, these data show that if you try, you can help some of these babies survive, and some of these babies could turn out to be just fine. But a lot of them won't make it, and those that do make it will be left with serious complications, so this will help doctors and parents try to struggle through these horrible decisions.

SIEGEL: What's the relevance of this study to the abortion debate?

STEIN: That - as you know, the Supreme Court has ruled that abortion is legal before a baby is viable outside the womb. But the definition of viability has been left up to doctors to decide. So the abortion rights advocates that I've spoke to today said this really shouldn't change much of anything at all. But viability is usually defined at 24 to 25 weeks, so some of the abortion opponents that I talked to today said, well, this data could support some of the laws that states have been passing to restrict abortions earlier and earlier in the pregnancy.

SIEGEL: Rob, thank you.

STEIN: Nice to be here.

SIEGEL: That's NPR's Rob Stein on a new study released today showing that babies born at 22 weeks can survive. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.