More babies born at 22 weeks’ gestation are surviving to go home from hospital, analysis suggests.
The study, published in the journal BMJ Medicine, said, however, that the survival rate of such extremely premature babies remained low.
Researchers set out to examine the impact of guidelines introduced in 2019 by 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, after an assessment of risks and in discussion with parents.
Researchers looked at 1,001 babies who were alive when their mothers went into labour at 22 weeks.
Before the change in guidelines, in 2018-19, only 11.3 per cent of them received care aimed at their survival. This rose to 38.4 per cent in 2020-21.
Admissions to neonatal units rose from 7.4 per cent to 28.1 per cent, and survival to discharge from neonatal care rose from 2.5 per cent to 8.2 per cent. The number of 22-week babies admitted to neonatal care units who died before discharge also rose from 26 to 95 as overall admissions rose.
The researchers, from the University of Leicester and Imperial College London, said their findings suggested that attempts to save babies born at that gestation were becoming relatively standard.
“Although the recommendation was intended to be risk-based, we speculate that, on the contrary, approaches have moved from being selective to more widespread provisions of survival- focused care. This change would explain the increase in the proportion of babies at high risk who received survival-focused care,” they said.
They added that there were resourcing implications not only for neonatal units but for maternity care, with more women moved to specialist hospitals before birth. “This represents an important increase in workload and need for specialised health care and educational resources,” the researchers said.
•The proportion of new mothers in England who feed their babies with formula and breast milk has increased, figures from the Office for Health Improvement and Disparities show. In 2022-23, 17.7 per cent of babies aged six to eight weeks were “partially breastfed”, up from 14.6 per cent in 2018-19.
