Premature baby's fate depends on more than age, study finds

By Gene Emery

BOSTON (Reuters) - Four factors beyond gestational age influence whether an extremely premature baby will survive and grow up healthy, U.S. researchers reported on Wednesday.

Girls, babies that weigh more and babies that do not have a twin all survived premature birth better, as did babies whose mothers were treated with steroids to hasten the development of the lungs, the researchers reported in the New England Journal of Medicine.

These factors also lowered the risk of neurodevelopmental problems such as blindness, hearing loss, thinking problems and cerebral palsy.

"Using the five factors in combination really gives you a better idea of how children are going to do, rather than singling out a single factor," Dr. Rosemary Higgins of the National Institute of Child Health and Human Development (NICHD), who worked on the study, said in a telephone interview.

The findings are designed to help doctors and patients decide whether to give aggressive treatment or only comfort care to such children.

Usually, doctors treat an extremely premature infant primarily on the basis of its gestational age, but they cannot always tell with certainty when a child was conceived.

The researchers, led by Jon Tyson of the University of Texas Medical School at Houston, studied 4,446 infants born 22 to 25 weeks after conception. A full-term pregnancy lasts 40 weeks.

They said 49 percent of the infants in the study died and 21 percent survived without a disability based on tests done when they were about two years old.