Improved Survival Rates for Extremely Premature Infants as Active Interventions Rise

Recent research has demonstrated a significant increase in survival rates among extremely premature infants, particularly those born between 22 and 25 weeks of gestation. Led by epidemiology associate professor Nansi Boghossian, the study analyzed data from nearly 60,000 births across 795 NICUs in the United States, spanning from 2014 to 2023. The findings reveal that a concerted effort to implement active medical treatments—such as ventilation support, surfactant therapy, and other life-sustaining interventions—has resulted in improved outcomes.

Specifically, the study observed that active treatment approaches for infants born at 22 weeks' gestation increased from 28.8% in 2014 to 78.6% in 2023, with survival rates rising from 25.7% to 41.0%. Similarly, for infants born at 23 weeks, active treatment increased marginally from 87.4% to 94.7%, and survival rates improved from 53.8% to 57.9%. These trends indicate a shift toward more aggressive intervention strategies, which are now associated with better survival outcomes.

The researchers defined active treatment as interventions encompassing face mask ventilation, nasal continuous positive airway pressure, endotracheal intubation, surfactant administration, mechanical ventilation, chest compressions, or epinephrine. They also examined variations across different racial and ethnic groups, finding that Black infants were more likely than white infants to receive active treatment at these early gestational ages. The overall increase in both active treatment and survival can be attributed to advancements in medical technology, updates in clinical guidelines, and a growing body of evidence supporting earlier and more intensive intervention in extremely preterm births.

This growing body of evidence challenges previous perceptions regarding the lower limits of viability and underscores the importance of evolving medical practices to improve outcomes for some of the tiniest and most vulnerable infants. The findings highlight an important advancement in neonatal care, emphasizing the role of technological progress and clinical guidelines in saving lives that were previously considered unlikely to survive.

For more detailed information, refer to the full study published in the Journal of the American Medical Association. Source: https://medicalxpress.com/news/2025-09-survival-extremely-premature-infants-treatment.html