Extreme preemies likely to face disabilities: study

Despite medical advances, premature babies are still more likely to die or face significant learning and physical disabilities by the time they reach school age, a new study has found.

Scientists have long recognized that developmental problems are common among extremely premature "miracle babies," but the long-term consequences have been unclear.

Parents and doctors have been seeking more information to help them to decide when to use heroic measures to save babies born earlier and smaller.

Dr. Neil Marlow, a neonatologist at the University of Nottingham in England, and his team tracked extremely premature births in Britain and Ireland in 1995.

Normal pregnancy is 37 to 42 weeks. The babies included in the study were born when their mothers were between 22 and 25 weeks pregnant.

Of those who were born alive, only 25 per cent survived and went home from hospital, the researchers reported in Thursday's issue of the New England Journal of Medicine.

By the time these children reached the age of about six, Marlow and his colleagues found:

• 46 per cent of the children had severe or moderate disabilities such as cerebral palsy, vision or hearing loss and learning problems.
• 34 per cent were mildly disabled.
• 12 per cent had disabling cerebral palsy.

About 20 per cent had no disabilities.

Intelligence test scores suggested 41 per cent of the extremely premature children had moderate or severe learning disabilities, compared to classmates who were born at full term.

Pressure to save babies growing

The rate of premature births is increasing in developed countries, partly because of a rise in older mothers and multiple births from reproductive technologies.

Guidelines from the American Academy of Pediatrics recommend not resuscitating infants born at less than 23 weeks or weighing less than 400 grams at birth.

Despite that, parents may pressure clinicians to try to save their babies, Dr. Betty Vohr and Dr. Marilee Allen wrote in a journal commentary. Publicity surrounding "miracle babies" also contributes to the pressure to use every medical technique possible to save the lives of preemies.

The pair said Marlow's study provides essential information to help neonatalogists and parents make their decisions.