Dive Brief:
- A new study in the New England Journal of Medicine has taken a detailed look at U.S. premature birth outcomes based on the extent of active treatment the infants received vs. comfort care.
- The research group run by the National Institutes of Health looked at approximately 5,000 babies that were born before 27 weeks gestation at 24 different hospitals.
- The hospitals' actions had "a dramatic influence" on the infants' outcomes, the study concluded.
Dive Insight:
The study raises multiple ethical considerations as it highlights the range of approaches that hospitals take in caring for extremely premature infants. Of the 24 hospitals studied, four hospitals never provided active treatment for babies born at 22 weeks, while five others always did.
While experts note that treatment may not always be the right choice, the data showed that it does improve survival odds and reduce rates of severe impairments for those who do survive. With active treatment, 22-week babies had a 23% survival rate compared to 5% overall, and they achieved survival without severe impairment at a rate of 15% compared to 3% overall.
Perhaps most notably, however, the study raises the issue of how hospitals communicate about preemie care with parents. The researchers suggest that parents should be aware of how their choice of hospital could impact their baby, and that hospitals need to provide accurate information about survival odds when determining a course of treatment. "A doctor might say 'no 22-week infant has ever survived,' but that might mask the fact that doctors there don't try, because they don't consider such babies viable," said researcher Matthew Rysavy.