An estimated 15 million babies are born prematurely, before 37 weeks of gestation, every year worldwide. Of those, about 5–6% are born extremely prematurely, before 28 weeks of gestation. Progress in the perinatal care of these babies has continued to improve outcomes in high-income countries.
The British Association of Perinatal Medicine has issued new guidance, Perinatal Management of Extreme Preterm Birth before 27 weeks of gestation. For example, even at the lowest end of viability, at 22 weeks of gestation, 30% of those babies who were given active treatment survived to discharge in cohort studies from Sweden, the US, and Germany. And in the UK, 88% of babies born at 23 weeks of gestation will receive active respiratory care, with 38% surviving to age 1 year.
The guidance offers a welcome new framework for decision making and managing these infants.