No Intensive Care for Dutch Babies Under 25 Weeks

According to a news article in the British Medical Journal (BMJ), doctors in The Netherlands have decided that preterm babies born prior to 25 weeks of gestation will not receive active intensive treatment because research shows they have a poor prognosis. Many babies born earlier than 25 weeks do not survive, and those who do survive face the likelihood of developing serious problems later on.

The University Medical Center in Leiden (The Netherlands) decided to increase the limit from 24 to 25 weeks because of a study conducted by the center on premature births from 1996-1997. This study revealed that out of all preterm babies born at 23 and 24 weeks, 66% died. Moreover, half of those who survived suffered from severe mental or physical handicaps by the time they were two years old. In contrast, 60% of preterm babies born at 35 weeks died and those who survived had fewer handicaps.

The decision to change the limit was made just as the results of another study were made public. This was a 14-year joint study conducted by the Leiden center and a Dutch research group that collected data on 1,338 babies born at 32 weeks or sooner or whose birth weight was 1,500 g or less. The outcomes showed that 30% of the babies died within two years, and 10% of these had a severe disability or handicap. Although by school age the others had no severe disability, half had serious difficulties in their everyday life. "The burden of these mild developmental abnormalities and behavioral and learning disorders increases with age,” concluded the authors.

The chairman of the ethical committee of the Dutch Association of Pediatric Medicine, Dr. Louis Kollee, said that the 25 weeks was not a sharp cut-off point but, rather, a guideline not to immediately offer intensive treatment following delivery but to consider each case on its own merits.





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British Medical Journal