Every Day Matters for Preemies

One of the most memorable moments in life is bringing a newborn home from the hospital. It is joyful, emotional, and, let’s face it, a bit frightening. They are thrust into a world filled with feeding schedules and sleepless nights. And they have never imagined the anxiety that comes along with it. Each cough, cry or missed nap can seem monumental. Parents of premature babies, those born before the 40-week mark, are faced with unimaginable parenting concerns. Every Day Matters for Preemies.

Imagine being told that your baby only has a 32% survival rate without major disabilities. Some parents are faced with this harsh reality when their baby is born after only 23 weeks of gestation. This is a period of fear, anxiety, and hope.

There is good news. There’s amazing news.

The survival rate for premature babies has improved dramatically thanks to decades of research and groundbreaking advances in neonatal intensive care. New data paints a more positive picture for families navigating those early, emotional days in the neonatal care unit (NICU).

The Premature Delivery Revolution: Every Day Matters for Preemies

In the past few decades, babies who were born before 28 weeks of gestation had little or no chance of surviving. In the 1970s, survival rates were around 10%. Fast forward to today, and this number has soared. Now, more than 75 per cent of these fragile babies survive with intensive care. This medical breakthrough saves thousands of little lives every year.

It’s no longer just about survival. It’s not just about survival anymore.

A new, remarkable study published in Child and Adolescent Health can help. Researchers at the Royal Women’s Hospital in Melbourne and the University of Melbourne were able to update, realistic and more optimistic figures about the risks and progress of extremely premature babies.

First-time doctors can offer parents an accurate picture of their baby’s progress as they get stronger in intensive care. Every day is important.

What Survival Looks Like Over Time: The Power of Progress

Research has shown that babies born before 28 weeks still have a higher mortality or disability risk than those born at full term (37-42 weeks), but most survive with intensive care. It’s even more encouraging to know that a majority of babies who are sent home will not suffer any long-term disability. 83%. This compares with 97% for full-term babies.

Take a look at the baby at 23 weeks. The outlook at birth is bleak. What are the chances of surviving a major disability-free? Only 32%. That’s just the beginning.

If a baby born after 23 weeks can survive their first week of life without significant medical complications, the chances that they will live without major disabilities increase from 32 per cent up to 50 per cent. This is a significant increase, says Associate Professor Jeanie Chong, the lead researcher in the study.

By the time the same baby leaves the hospital, its odds have increased even further. There’s now a 70% chance that they will survive without major disabilities, which has more than doubled since birth. The shift in odds shows how important the first few weeks of intensive care can be.

Many families do not hear the updated statistics. The scary statistics of their baby’s birth are etched in their minds, and they never know how much has improved since their baby’s time in the NICU.

“It’s important to be able to tell parents that their baby’s chances of survival have significantly improved,” says Associate Prof. Cheong.

What are these numbers? The Victorian Infant Collaborative study (VICS).

How do we know this?

The Victorian Infant Collaborative Study, or VICS, is a long-running and comprehensive study of premature babies. The study tracks all babies born before 28 weeks in Victoria, Australia, over several generations, including 1991-92 and 1997, 2005 and 2016-17.

Associate Professor Cheong says that VICS is quite amazing. In the 1990s, we saw a revolution in the survival rate of tiny babies. Some visionary doctors were interested in what happened to these babies over the long term.

The late Dr. Bill Kitchen was one of these pioneers. He worked with several hospitals, including the Royal Women’s Hospital and the Royal Children’s Hospital. To make the comparisons more meaningful, they included a healthy control group.

VICS is unique today in terms of its reliability and scope. The VICS includes babies of all socioeconomic backgrounds and has a high follow-up rate. 91% of the participants are tracked through at least 8 years.

Associate Professor Cheong says, “These babies have grown into teenagers and young adulthood, and the lessons we’ve learned are invaluable.”

The Intensive Care Patient and the Key Risk Factors

The new research examined 499 people from three VICS cohorts, those born in 1991-1992, 1997 and 2005, who are now aged between 13 and 27. These babies were among the most fragile newborns and survived only because of state-of-the-art neonatal care.

The picture for babies born as early as 23 weeks is both sobering and hopeful. Initial survival rates with intensive care are around 45%. Only 30% of babies born at 23 weeks will survive without severe disabilities.

The story of those who survive the NICU journey changes quickly. When they are discharged from the hospital, their chances of dying drop to less than 1 per cent, and 70% may be free of major disabilities. This is a huge shift.

The higher the chances of a healthy baby are, the older the child is when they’re born. For example, if the baby was born at 27 or 25 weeks rather than 23 weeks. Every additional day spent in the womb has a significant impact.

The study also identified four clinical events that could increase the risk of disability in the long term during the NICU stays:

1. Major brain injuries diagnosed by postnatal ultrasound
2. Corticosteroids are a medication that prevents or treats lung injury.
3. Necessity of surgery during the neonatal period
4. Multiple major complications in intensive care

These risk factors will help doctors and health care teams plan better for long-term support and follow-up, so that children at high risk receive the help they require early on in their lives.

What this means for parents – and why mental health matters

A premature baby can be emotionally draining. The NICU can be a place filled with constant monitors that buzz, medical jargon and a sense of anxiety. Every day, parents are on an emotional rollercoaster.

Associate Professor Cheong says, “We know anxiety and depression are significantly higher among parents of pre-term babies.” The mental health of parents affects the development of their children.

This is why the new research is important. By giving parents real-time, up-to-date information about how their baby’s chances are changing–improving–as the days go by, clinicians can help alleviate some of that anxiety. Although knowledge doesn’t remove uncertainty, it can give parents something they desperately need: hope.

Parents can make more informed decisions and feel more confident about their baby’s future care. They are also able to see the future more clearly. This may improve their bonding with their baby and how they care for them after returning home.

Look Ahead: A Better Future for the Tiniest of Lives

This study has revealed some profound findings. The majority of premature babies will survive. More than that, the majority of these little fighters will be able to grow up with no major disabilities.

Every day that passes in the NICU improves their chances. Each hour their lungs grow stronger, their hearts stabilise, and their tiny bodies develop, they are closer to home – and a life full of possibilities.

Families with extreme prematurity no longer have to be in the dark. Real data, real progress and real hope are given to them.

Every day counts when it comes to premature babies.