For anyone that has ever had a baby, you likely understand the importance of making it past 24 weeks of gestation. Babies born after 24 weeks has a more than 50% chance of surviving which steadily increases as gestation continues. Before 24 weeks, however, the odds of survival for an infant are significantly lower.
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Currently, the youngest children at birth to ever survive were 21 weeks 5 days and 21 weeks 6 days. The most recent of the two youngest surviving children was born in 2006 and weighed only just over 283 grams at birth. When it comes down to just which babies survive, it depends much on chance as well as the neonatal doctor.
Life outside the womb
As medicine has progressed and doctors have become more adept at facilitating life outside the womb at such early ages, the age of viability, or age when a child can survive, has slowly crept earlier and earlier. For the last decade or so, the age has hovered around a general consensus of 24 weeks gestation. Before this, the age was higher and higher the further back we travel in medicinal history.
Keeping an infant alive before 24 weeks, or even just around 24 weeks in age, has a lot to do with the medical technology we have available to us. As the medical industry has developed a better understanding of infection and intensive neonatal care, environments more similar to human wombs can be created within the confines of hospital walls. With that said, for the most preterm babies that are born, before 24 weeks, their survival rate depends much on whether doctors will treat them.
A 24 week age of viability simply means that this is the point after which most babies will survive birth. This doesn't mean that survival isn't possible before this age. When a baby is born before 24 weeks, a doctor can determine whether treatment is beneficial or hindering to a baby's well-being. The risks of developmental issues and mental retardation are high for children born this young, so often times, doctors can determine that attempting to save a preterm baby might cause more harm to their life than if they were allowed to die or survive on their own.
With that said, the decision isn't just left up to doctors. Parents can insist that doctors try to save a given preterm baby and generally, doctors will try as long as said baby is over 500 grams. Much of the survival of very preterm babies are also due to the medical equipment and medical knowledge at the hospital where a child is born. Transporting a baby born before 24 weeks essentially voids any chance at survival of the infant. Due to this, much of the early surviving babies throughout history have been because they were born at a hospital that could handle such intensive care.
While the age of viability has stagnated in recent years, new advancements may bring the age even lower. Most recently, development of an artificial womb that successfully grew a baby sheep could prove to be an integral technology for future babies' survival. One recent study suggests that if properly treated, babies born before 24 weeks but after 22 weeks will survive. This doesn't mean the survival rate will be 100%, but rather that precise treatment administered correctly, often with luck, would allow a baby to survive.
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The continued pulling back of the age of viability means great things for the preservation of people's children. Thousands of families around the world now have healthy children thanks to advances in medical technology that have brought the age of viability down.
The other aspect to the advances in the age of viability also leads to tough questions in the political and human rights realm. It may surprise many, but there is no legal age of viability in place for abortion in the US. The line, rather, is blurred to doctors' discretion. New studies suggesting viability before 24 weeks are driving a push to bring the legal age of abortion back to 20 weeks gestation. The issue, while politically controversial and enthralling, is continuing to be defined by the age of viability progressed backward due to advances in science and medicine.
Moving forward, it seems that the age of viability will move forward at slow paces in the future barring any huge breakthrough, such as an artificial womb. Without technology like an artificial womb, there will be a theoretical limit at which life of a preterm baby will not be sustainable under medical supervision. That limit, however, has not yet been defined.
Written by Trevor English