Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, November 25, 1993 TAG: 9311250064
SECTION: NATIONAL/INTERNATIONAL PAGE: A10 EDITION: HOLIDAY
SOURCE: Associated Press
DATELINE: BOSTON LENGTH: Medium
The study found that those born at 25 weeks have a good chance of surviving without major birth defects. Those who enter the world at 22 weeks are almost surely doomed to die.
"At 23 and 24 weeks is where the dilemma is," said Dr. Marilee C. Allen. "There were many deaths and many had severe abnormalities."
Once such tiny preemies were almost certain to die. But in recent years technology has given doctors the power to at least try to save them.
However, if babies are born too young to benefit, such treatment will only prolong their deaths, not save their lives.
The new study was based on a review of 142 babies born at 22 to 25 weeks gestation over 2 1/2 years at Johns Hopkins Hospital in Baltimore. The findings were published in today's New England Journal of Medicine.
When babies are born too soon, their lungs are so immature that they cannot breathe on their own, and their heads are so fragile that they often suffer brain damage.
The doctors found that none of the infants born at 22 weeks gestation survived for at least six months. By comparison, 15 percent born at 23 weeks lived at least six months, as did 56 percent born at 24 weeks and 79 percent at 25 weeks.
However, survival did not necessarily mean good health. Only 2 percent of those born at 23 weeks escaped severe abnormalities, compared with 21 percent born at 24 weeks and 69 percent at 25 weeks.
Allen said she hoped the findings will be used to help parents decide how their child should be treated, assuming there is time for a discussion before premature labor begins.
Babies are considered to be premature if they are born before their 37th week in the womb. Prematurity is the major cause of newborn deaths and health problems.
Another report in the journal raised concerns about one of doctors' major drugs for preventing premature births. The medicine, indomethacin, has been used for 20 years to stop premature labor.
However, the study found that when the drug fails to work, it seems to harm the health of premature babies.
Dr. Mary E. Norton and others from the University of California, San Francisco, studied 114 babies born between 24 to 30 weeks gestation. Half of their mothers had gotten indomethacin in unsuccessful efforts to postpone their births, and half did not.
They found that the babies in the indomethacin group had significantly more bowel disease, bleeding in the brain and heart and kidney problems.
However, the study did not figure out whether the drug's success in delaying delivery outweighs these hazards.
"These papers serve to remind us of the experimental nature of current treatment of infants before and after birth," Drs. Maureen Hack and Avroy A. Fanaroff of University Hospitals of Cleveland wrote in an editorial in the journal.
by CNB