More babies are surviving being born prematurely at 22 weeks

More babies born at 22 weeks are surviving to discharge from hospital, research suggests.

A study published in the journal BMJ Medicine examined data following new guidelines introduced in 2019 from the British Association of Perinatal Medicine.

Previously, it was recommended that only babies born at 23 weeks or later were given treatment to save their lives.

But the updated guidance said "survival-focused care" (such as respiratory support) should be an option for babies at 22 weeks' gestation following an assessment of risks and in discussion with parents.

Though overall survival at this age remains low, the latest study found more babies than previously are surviving to be discharged from hospital and more are receiving treatment.

The research included 1,001 babies who were alive at the onset of labour at 22 weeks' gestation.

When comparing 2018-19 figures (before the change in guidelines) and those for 2020-21, the proportion of babies receiving survival-focused care rose from 11.3% to 38.4%.

Meanwhile, admissions to neonatal units rose from 7.4% to 28.1%, and survival to discharge from neonatal care rose from 2.5% to 8.2%.

More babies of lower birth weight (less than 500g) also received survival-focused care (46% rising to 64%).

At the same time, the number of babies admitted to neonatal care units who died before discharge also increased from 26 to 95.

The researchers, including from the University of Leicester and Imperial College London, said their findings suggest "four in 10 babies alive at the onset of care in labour will be expected to receive survival-focused care; two in 10 babies who receive survival-focused care and three in 10 admitted to neonatal care would be expected to survive to discharge (ie, seven in 10 die); and one in 10 babies admitted to neonatal care are expected to survive to discharge without major morbidities... although their long-term outcomes are not known".

The experts added: "While survival for babies born at 22 weeks remains low, the numbers receiving survival-focused care and being admitted to neonatal units has tripled.

"Although this finding suggests that the total number of survivors has increased, this result also means that the number of babies who died after intensive care also increased.

"Maternity care was also affected because of likely increases in in-utero transfers (ie, moved to a specialist hospital before birth), as well as impacts on paediatric and educational services to provide for long-term health and developmental needs.

"This change represents an important increase in workload and need for specialised health care and educational resources."

Once babies get past 22 weeks, the chances of survival increase week-by-week.