About one in 10 American babies is born preterm, defined as prior to 37 weeks into their mother’s pregnancy, according to the U.S. Centers for Disease Control and Prevention. But fewer than 1 percent of preemies are born not just weeks but three or more months before their due dates—an extreme level of prematurity that threatens survival and can pose lifelong health complications for the tiniest babies.

Until about 1980, babies born at or before 24 weeks’ gestation were almost certain to die, according to the American College of Obstetricians and Gynecologists (ACOG). But the age of viability—when a premature infant can potentially be saved with intensive medical support—has steadily crept to earlier points.

Some tiny infants weighing a pound or less are now able to be saved at 23 or even 22 weeks of gestation, says Jocelyn Austria, M.D., a neonatologist at JFK University Medical Center. “We’ve come a long way,” she says.

Fewer than 6 percent of babies currently born before 23 weeks survive, according to ACOG, and the vast majority who do deal with long-term medical problems. But three-quarters of babies born by 25 weeks of gestation will survive to be discharged from the hospital.

“With extremely premature babies, if equipment available can’t fit the baby because they’re too small, that’s unfortunately a barrier to survival,” explains Brittany Reid, M.D., director of neonatology at JFK.

Vulnerable to Long-Term Challenges

The vast majority of premature babies are born 34 or more weeks into their mother’s pregnancy, Dr. Austria notes. Even though they’re larger by this point, “these babies are vulnerable, so we need to be careful with them,” she says.

Depending on gestational age, preterm babies can face medical challenges such as:

• Breathing problems
• Feeding difficulties
• Developmental delays
• Vision problems
• Hearing problems
• Cerebral palsy

That’s because the final weeks and months of pregnancy fuel the maturity of vital organs, such as the brains, lungs and liver.

“Prematurity in general raises the risk of developmental delays such as not talking on time or rolling over—milestones we look for as babies get older,” Dr. Reid explains. Every additional week a pregnancy can continue after 26 weeks greatly raises the chances a baby will live and thrive.

“There are different levels of delays and long-term effects,” Dr. Reid adds, “but the vast majority of babies born at 28 to 30 weeks and beyond can survive without significant complications. At less than 28 weeks, survival is possible, but the risk of long-term complications is much higher.”

Next Steps & Resources:

• Learn more about excellent care before, during and after delivery at JFK University Medical Center.
• Meet our sources: Jocelyn Austria, M.D. and Brittany Reid, M.D. To make an appointment with Dr. Austria, Dr. Reid or another doctor near you, call 800-822-8905 or visit our website.

The material provided through Health Hub is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.