The statistical challenges of saving an extraordinary preemie

Part of a special report from the Tampa Bay Times on extremely premature births and the advances in neonatal care that can make survival possible. The statistical challenges of saving extraordinary preemies Early arrival kills more newborns than anything else, and complications from early arrival kill more babies in their 24 28 Loosely considered the limit of human Nearly all babies born at this gestation weeks will survive. viability outside womb weeks first year than anything else. Every week of pregnancy marks a milestone of 22 35 The respiratory center in the brain Very few doctors will resuscitate. matures. weeks weeks development critical to survival. 750 Baby would be considered a miscarriage if born earlier than weeks :20 25 36 conidened 36 weeks Considered weeks full term in Most doctors feel morally and legally obligated to try to save a baby's life. babies are born in the zone between viability and futility, 22 to 25 weeks of gestation. Born at 23 weeks The baby shown here was born on April 12, 2011, in St. Petersburg, Fla. A baby like the one shown here, born at 23 weeks 6 days, 11.4 inches long and weighing 1 pound 4 ounces, has a chance Odds this baby would die or be at least Odds this baby would die or be profoundly disabled. 80% 68 moderately disabled. to survive now thanks to medical advances that have A micropreemie is a baby born before about 26 weeks of gestation and weighing less than about 1 4 pounds. increased the viability of micropreemies. Odds this baby would die 53 no matter how hard the doctors tried to save her. The gray zone of viability With every week that a baby remains in utero, the chances of survival improve. Thirty years ago, the limit of viability was around 28 weeks. Now it is much earlier. Chances of survival per week of gestation 5% 26 56% 75 22 23 24 25 weeks weeks weeks weeks 99% 38 Chance of death or moderate %, to severe disability decreases with each passing week. U.S. is among countries with the highest number of preterm births. Top causes of early labor 500,000. Statistics 11.7 Often parents never learn why babies come early, but socioeconomic, biological and environmental factors can increase the risk of preterm birth. of babies were • Having a previous premature birth • Carrying more than one baby • An interval of less than six months %, born prematurely in the U.S. in 2011 out of between pregnancies • Conceiving through in-vitro fertilization • Problems with the uterus, cervix or placenta • Smoking cigarettes, drinking alcohol or using illicit drugs • Poor nutrition • Some infections during pregnancy • Some chronic conditions, such as high blood pressure and diabetes The world's smallest baby was born in weighing 13 3 Зл. 2004 9.2 years at 25 weeks of babies were born prematurely in Florida in 2011. has dropped in Florida. in a row that the premature birth rate Rumaisa Rahman survived without major health problems. Costs of care are daunting Hospital bills for preemies can be staggering. A typical preemie birth costs ten times what a birth for a full-term baby costs, and micropreemies are exponentially more expensive. Still, experts say neonatal care many years of useful life. a bargain in medicine, because it can buy 226 A50.4.5 L.. VS VS bil. Lmil.+ average cost of neonatal care for preemies average cost for a normal birth in the United States typical cost of an extremely preterm baby annual cost of prematurity in the U.S. in 2006 90 of costs for babies born prematurely were paid by employer health plans when moms were insured. 48 of hospital stays for preterm infants were covered by Medicaid. Never let go: a micropreemie's story Visit tampabay.com/neverletgo to read the story of a baby born four months early. Her arrival strained the limits of what is possible and what is right. Babies born so early look like tiny, gasping aliens, eyes fused shut, skin so translucent you can see their hearts flicker. The newest and most aggressive treatments can sometimes save them, but 80 percent will die or end up disabled. In April 2011, Kelley Benham's baby was born into this awful calculus. She and her husband faced impossible questions. Was the dream of a healthy baby too much to hope for, the cost of saving her too high? And if so, did they have the strength to let her go? Benham, a prize-winning writer and editor, tells her story in a three-part series. Sources: March of Dimes, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Dr. William Sappenfield, Professor and Tampa Bay Times Department Chair at USF Health. Research assistance from Natalie Watson. Photo: Cherie Diez | Times Graphic: Kelley Benham, Lee Glynn | Times tampabay.com