Survival of very premature babies has failed to improve

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The survival of very premature babies has not improved in the past 15 years despite more intensive treatment, a study has found.

Although survival rates for babies born at 24 and 25 weeks' gestation have increased, rates for those born at 22 and 23 weeks do not appear to have changed, experts said. Despite the fact they are increasingly being actively treated and for significantly longer in intensive care, the outcome is still the same.

The researchers in Newcastle point out that, as survival rates for babies born at 24 weeks and above have increased, this may be why those born under 24 weeks are increasingly being actively treated as well.

The experts analysed infant deaths among 229 babies born alive at 22 or 23 weeks' gestation, considered to be at the margin of viability, in Newcastle from 1993 to 2007. There were 210 deaths and just one in three lived for more than six hours.

The length of time the babies lived gradually increased between 1993 and 2007, reflecting lengthier and more active treatment, such as resuscitation and surgery. But chances of survival did not improve. Six babies survived between 1993 and 1997, six survived between 1997 and 2002 and seven survived between 2003 and 2007.

Writing in the journal Archives of Disease in Childhood, the experts concluded: "Over the last 15 years, increasing numbers of babies of less than 24 weeks received active resuscitation. Overall survival has not changed, but non-survivors endured significantly longer durations of intensive care.

"Some will feel that the prolonged periods of intensive, but unsuccessful, care are either futile or inappropriate. An improved understanding of societal and parental attitudes towards the withholding of active treatment at the margins of viability is needed."

Previous research has shown that babies born after fewer than 26 weeks of pregnancy that survive into childhood are more likely to suffer physical and mental problems. A high proportion are growing up with disabilities ranging from being unable to walk to learning difficulties.

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