Aggressiveness Key in Saving Preterm Infants

May 21, 2015

Earlier this month, a team of researchers released a study that found one major difference between life and death for extremely preterm infants—those born from 22 to 26 weeks of gestation—was how aggressively the doctors attempted to save the babies’ lives.

Dr. Edward Bell, professor of pediatrics in the Stead Family Department of Pediatrics at the University of Iowa Hospitals and Clinics, was one of the authors of the study. He says they wanted to find why, when all 24 hospitals they studied were advanced academic medical centers, there was so much variance in the survival of preterm infants.

“At 22 weeks, which is the earliest gestational age where survival was possible, there were a number of hospitals in which no babies were actively treated, and there were five or six hospitals at which all babies were actively treated. At 23 weeks, there were still a very wide range.”

He says the differences in survival rates hospital to hospital correlated to the difference in approach; the more aggressive doctors tried to actively care for the infants, the higher the rate of infant survival.

The study raises questions on what the age of viability should be, a contentious issue, given that the Supreme Court has said states must allow for abortion if the fetus is not viable outside the womb. The current standard is cited as 24 weeks by most medical experts.

Dr. Lauris Kaldjian, Director of the Program in Bioethics and Humanities at the University of Iowa Carver College of Medicine, says important studies like this one bring up important ethical questions, about suffering, patient-doctor communication, and the nature of personhood, that deserve careful examination

“Science can only do so much for us. There’s no textbook that we can find or pull of the shelf or bring up online that can give us ‘the right answer’ to what to do. We have remarkable studies now from people like Dr. Bell and his colleagues that give us a lot of really important statistical information. Human beings are still going to have to interpret this and weigh it and assess it.”

On this edition of River to River, host Ben Kieffer talks with Kaldjian and Bell. Tundi Brady, the mother of a child born at 23 weeks, also joins the conversation.