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What to Expect When You Have an Extremely Premature Infant - Topic Overview

Infants born between 22 and 26 weeks of pregnancy are called "extremely premature." If your infant is born this early, you likely will face some hard decisions.

Your premature infant has a much greater chance than ever before of doing well. A baby has the best chance of survival in a neonatal intensive care unit (NICU) that has a staff with a lot of experience.

When a baby is born too early, his or her major organs are not fully formed. This can cause health problems. Your infant may not respond well to attempts to keep him or her alive. Often it's not clear whether treatment will help an infant live—with or without disability—or will only make the dying process take longer. A specialist called a neonatologist can give you some idea of what may happen. But no one can predict what exactly will happen. In the end it will be up to you to decide how far to continue treatment.

Having a premature baby may be stressful and scary. To get through it, you and your partner must take good care of yourselves and each other. It may help to talk to a spiritual adviser, a counselor, or a social worker. You may be able to find a support group of other parents who are going through the same thing.

What can you expect after an extremely premature birth?

If the baby can't breathe, the first decision that may be faced by parents and doctors is whether to resuscitate the infant. This means bringing the baby alive by getting the heart and lungs to work. When resuscitation doesn't work or isn't done, babies get care that makes them comfortable instead of treatment to keep them alive.

Treatment decisions are usually based on whether the infant's brain has been damaged. This can happen from bleeding in the brain or a lack of oxygen. Other things that affect treatment decisions include how physically healthy the baby looks and how many weeks old the baby appears to be.

The first month after the birth is when most major problems occur. It is a critical decision-making period for parents. There may be laws in your area that affect your decisions. Talk to your doctor about this.

How many of these babies survive being born?

The more premature the baby is, the lower the chances of survival are. Very few infants survive when they are born at 22 to 23 weeks of pregnancy. The table below shows estimates based on two sources.

Chances of survival1, 2

Weeks of pregnancy

Survival rates

23

Nearly 2 to 3 out of 10 survived (about 7 to 8 out of 10 died)

24

5 out of 10 survived (5 out of 10 died)

25

Nearly 8 out of 10 survived (about 2 out of 10 died)

It's important to remember that research results are only general numbers. Everyone's case is different, and these numbers may not show what will happen in your baby's case.

1|2

WebMD Medical Reference from Healthwise

Last Updated: March 22, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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