What is extreme prematurity?
Infants born between
22 and 26 completed weeks of pregnancy are called "extremely premature." An
infant's chances of survival greatly increase with each additional week of
pregnancy. A baby has the best chance of survival in a neonatal intensive care
unit (NICU) that has modern equipment and a staff with a lot of
What are the risks of surviving extreme prematurity?
As many as half of all toddlers who have survived birth before 25
completed weeks' gestation or weighed
750g or less at birth
have one or more moderate or severe disabilities, including:1
Sadly, neurologic problems cannot be diagnosed until well
after an infant has stabilized. The risk for cerebral palsy can be estimated no
sooner than 28 days after birth, when certain patterns of brain damage can be
Learning disabilities are often not detected until the
early school years. And behavioral problems such as
attention deficit hyperactivity disorder (ADHD) may
not be noticed until the early childhood years.
doctors typically make medical decisions for extreme preemies based on whether
the brain has suffered damage from brain bleeding (intraventricular hemorrhage) or a lack of enough oxygen (oxygen deprivation). This type
of damage may be found using cranial
For more risk information,
see the Your Information section.
What can I expect after an extremely premature birth?
Try to suspend all expectations of what will happen after an extremely
premature birth. Although you may have a solid sense of what medical care you
will agree to after the birth, be prepared for that to change as you learn more
about your newborn. Advance estimates of fetal weight and
gestational age can be inaccurate enough that seeing a
newborn is usually necessary before making medical decisions.
Whether to resuscitate at birth is often the first medical decision faced
by parents and doctors.
- According to the American Academy of
Pediatrics, experts in neonatal resuscitation support the decision to not
resuscitate infants born at less than 23 weeks' gestation,
- Some doctors recommend trying to
resuscitate all 24- to 25-week newborns and basing treatment decisions on how
well an infant responds.
Very few infants survive birth at 22 and 23 weeks'
gestation, and most are offered "comfort care" instead of intensive care.
Newborns who survive an extremely premature birth follow an
unpredictable path. Experts have found that they cannot accurately predict an extreme preemie's chances of healthy survival
using a formula of various factors such as sex, gestational age, and weight
relative to age. But your infant's neonatal intensive care unit (NICU) team can
keep you fully informed about how well your infant is doing relative to his or
her age, whether any medical complications might cause long-term suffering or
disability, and what possible outcomes lie ahead.
For more information, see the topic