By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
A new government study finds that odds of survival have increased over the last twenty years for babies who are born extremely premature.
“Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012,” appeared in the September 8, 2015, edition of the Journal of the American Medical Association (JAMA). The study followed treatments and outcomes associated with 34,636 infants born at 22 to 28 weeks gestation (measured from a woman’s last menstrual period, or LMP, so the fetal age would be about two weeks less).
The study reviewed hospital records for extremely premature babies born at 26 academic centers participating in the Eunice Kennedy Shiver National Institute of Child Health and Human Development Neonatal Research Network. 
The study complements a study published in May in the New England Journal of Medicine. That study looked at the survival and outcomes of almost 5,000 babies born before 27 weeks gestation at 24 hospitals from 2006 -2011.
The results from the JAMA study were, likewise, extremely encouraging.
In 1993, 70% of babies born at 28 weeks or earlier survived. That number had risen to 79% by 2012.
Survival increased most significantly for babies born at 23, 24, and 25 weeks, who saw their survival to discharge rates go from 28% to 33%, 52% to 65%, and 68% to 81%, respectively, over that same time period.
Survival rates for babies born at 26-28 weeks were up as well in 2012. They reached highs of 87% for babies at 26 weeks and 94% for children born at 27 or 28 weeks.
Rates for children born at 22 weeks were up as well, though survival remained rare. Just 6% in the study survived in 1993, but it had gone up to 9% by 2012. Only a handful of babies in the study were born at this stage (relative to the numbers born at later gestations), but generally low survival rates are one reason why doctors try to take whatever medical steps they can to delay birth as long as possible.
The 20 authors of the study were also encouraged that higher numbers of the older preemies (27 and 28 weeks) were not only surviving but being discharged from the hospital without any major problems.
Increases in survival and reductions in major morbidity are attributed to improvements in care for these infants. Beyond measures to delay birth and give time for further development, neonatal departments were doing different things to help preemies breathe, for example, giving mothers steroids before birth to stimulate fetal lung development, using less invasive or aggressive measures with newborns like tracheal intubation, ventilation, and chest compression, or employing greater use of surfactants that help the babies’ lungs function. When a baby did have to be delivered early, Cesarean deliveries appeared to help the births be physically less traumatic for the children.
According to the U.S. Centers for Disease Control (CDC), there were about 450,000 preterm births in 2012. Up until 2006, the percentage of births that were preterm in the United States had been increasing at least as far back as 1981. The current rate, though, of 11.4% (for 2012) represents the lowest percentage in 15 years.
There are thought to be many possible causes of preterm births, some known (smoking, alcohol, drugs), others not. Researchers looking at data from dozens of studies from many countries covering multiple years have identified abortion as a significant risk factor associated with many preterm births, especially those very early preterm (most recently, see June 2015 NRL News).
As abortions have declined, and particularly those surgical abortions that may physically damage a woman’s reproductive system, the number of preterm births might also be expected to decline, as the data appears to show.
One good thing about this new study is that it demonstrates that with treatment, these babies’ lives can be and have been saved. If babies can make it to 22 weeks LMP (20 weeks fetal age), it may not be easy, but parents of early preterm babies do not need to be told that their situations are hopeless.
Nevertheless, there are locations in the United States where babies this same age can still be legally aborted. Even after the embarrassing expose’ of its fetal tissue “donation” practices, Planned Parenthood continues to advertise its willingness to perform abortions at 23 or 24 weeks at clinics in California and New York.
Others go even further. In the very first video from the Center for Medical Progress, Deborah Nucatola, Planned Parenthood’s Senior Director of Medical Services, helpfully offers the name of one of the “providers who go beyond 24 weeks.”
These babies are obviously human and clearly alive. This recent study shows us that because abortion is legal, the difference between those babies who live and those who die is not a matter of medical technology, but of our attitude towards human life.
 The article was authored by more than twenty neonatologists and pediatricians from institutions all over the United States. The lead author was Barbara J. Stoll of the Department of Pediatrics at the Emory University School of Medicine in Atlanta.