Doctors and parents having to make life and death decisions
about the treatment of very premature babies will now have better information thanks
to an online calculator that can tell more than just how long the infant was in
the womb.
The online calculator bases its decisions on a study led by
University of Texas Medical School at Houston
researchers who found factors such as weight and gender also strongly influence
outcome when babies are at the fringes of viability.
“This was born of some degree of frustration that we can’t
give these parents a better sense of their baby’s chances. At such sensitive
times, it’ll mark a significant improvement to be able to share evidence-based
data about how infants on average fare,” said Dr. Nehal Parikh, a University of Texas Medical School at Houston
professor of pediatrics and one of the study’s author, according to the Houston
Chronicle.
The researchers studied 4,446 infants born 22 to 25 weeks
after conception. A full-term pregnancy lasts 40 weeks. About 15,000 such
babies are born annually and they require aggressive intensive care to survive.
According to the study’s findings, 49 percent of the infants in the study died
and 21 percent survived without disability based on tests done when they were
about two years old.
“We found that bout half of the infants survived and that
about half of those who survived had neurodevelopmental impairments. This is a
very, very high risk group of babies,” Jon Tyson of the UT-H, who led the
researchers, said.
The study also found that, besides gestational age, birth
weight and sex, there were other factors which influenced these babies’ chances
of survival, such as whether the mother received prenatal steroids to help
fetal lungs mature and whether the infant was a single delivery rather than one
of twins or more.
How did sex and steroids influence the survival rate? Well,
according to the study, a 24-week-old two-pound male twin whose mother did not
receive steroids has survival odds of 69 percent and a 50 percent chance of
having a severe impairment. A female twin the same age and weight has survival
odds of 86 percent and a 23 percent chance of severe impairment.
Moreover, the study found that a week more or less spent in
the mother’s womb and the sex of the baby could tell a lot about chances of
survival. For example, a girl at 23 weeks could be as strong as a boy at 24.
Based on these findings, published in the April 17 New England
Journal of Medicine, the National Institute of Child Health and Human
Development, which funded the study, created a Web site that outlines the odds
of healthy survival in specific cases. This way, physicians and parents may
access an online tool that generates statistics, based on the factors the
researchers listed in their article.
“The researchers' findings, and the tool they developed, provide important
information that physicians and family members can consult to help them make
the most informed treatment decisions possible,” Dr. Duane Alexander, director
of the Eunice Kennedy Shriver National Institute of Child Health and Human
Development said.