13 May 2010
A recent study in the Archives of Disease in Childhood entitled ‘Survival in infants live born at less than 24 weeks' gestation: the hidden morbidity of non-survivors’ confirms the validity of recommendations made by the Nuffield Council on Bioethics in November 2006 on resuscitation and care of very premature or sick babies.
Whilst recognising that gestational age is not the only predictor of outcome, the 2006 Nuffield Council report recommended that resuscitation should only be attempted at 23-23 weeks if both parents and doctors agree and the latest research seems to support these guidelines. The latest study shows that survival rates for babies born at 24-25 weeks’ gestation have improved; but those for babies born before 24 weeks remain low, despite more active resuscitation efforts.
The Lancet comments, “Although advancements in active resuscitation and intensive care have greatly improved survival rates for babies born after 24 weeks, they unfortunately also seem to have provided stronger proof that the organs of babies born at 22—23 weeks are rarely sufficiently developed for even short-term survival”.
Leigh Day & Co clinical negligence partner Anne Winyard was a member of the Nuffield Council’s working party that looked at the difficult questions surrounding the treatment of very premature or sick babies. The working party examined the ethical, social, legal and economic issues involved in such critical care decisions and their 2006 report contained the first week-by-week guidelines on when to give resuscitation to extremely premature babies, the report can be found here.
Anne Winyard said:
"The Nuffield Council’s recommendations were intended to help parents and healthcare professionals when making often agonising resuscitation decisions and it is encouraging that our guidelines seem so far to have stood the test of time".
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