New setback to lowering abortion limit

Published on Thursday 8 May 2008 22:19

THE limit at which babies can survive after being born prematurely has been reached, researchers said yesterday, as debate continued over calls to update UK abortion laws.

A major study, published in the British Medical Journal, found that there had been no improvement in the survival rates of babies born before 24 weeks over the last 12 years.

The research came as MPs prepared to discuss whether the time limit for abortions should be lowered from 24 to 20 weeks.

Many have argued that the limit should be reduced because of improvements in the care and the increased survival rates of premature babies in recent years. But the latest study disputes this claim, with the researchers concluding the limit of viability had been reached.

Professor David Field and colleagues from the University of Leicester studied all babies born before 26 weeks in the Trent health region – serving a population of around 4.6 million – between 1994-99 and 2000-05.

Of the babies born at 23 weeks, there was no improvement in survival between the two periods, which remained at just 18 per cent. None of the 150 babies born at 22 weeks survived to leave hospital.

But the researchers did find a significant improvement in the survival of babies born at 24 and 25 weeks.

Overall, of the 497 babies admitted to intensive care in 2000-05, 47 per cent survived to discharge, compared with 36 per cent in 1994-99.

The researchers said their findings could not be explained by changes in obstetrics or neonatal resuscitation practices because a similar number of babies died in the delivery room during both periods.

The team said: "The analysis … showed no improvement in the survival of babies admitted to neonatal intensive care born before 24 weeks' gestation.

"In those born at 24 and 25 weeks, however, there was a markedly different pattern of improving survival. This suggests a significant improvement in the care of these slightly more mature infants (between the two periods monitored]."

The researchers said their findings concurred with the views of other researchers that "the limit of viability had been reached" for premature births.

Prof Field, a neonatologist at Leicester Royal Infirmary, said it did appear that there was a cut-off point under which babies would not survive no matter what treatment they received.

But he added: "We will always continue trying everything possible to help these babies."

Dr Tony Calland, chairman of the British Medical Association's ethics committee, said the research gave further weight to the BMA's view that there is no scientific justification for lowering the abortion time limit.

"Although the vast majority of abortions take place in the first trimester, there are still women who need abortion services later on in their pregnancy," he said.

"To lower the abortion limit would leave a number of women in dire circumstances."

Dr Andrew Ferguson, of the Christian Medical Fellowship, said: "Two-thirds of the public, two-thirds of GPs and three-quarters of all women want the upper limit (for abortion] reduced significantly. These findings will not alter their views and we urge Parliament to take public opinion into consideration."

RISKS OF EARLY BIRTH

EVERY year, about 7 per cent of babies in the UK are born prematurely – before the 37th week of pregnancy.

This amounts to 125 babies being born too soon each day, according to Tommy's, the baby charity.

In 2005, 4,174 babies were born prematurely in Scotland out of a total of more than 51,000 births.

Despite improvements in care, the number of premature births each year has not dropped significantly since the 1960s.

And it is hard for doctors to identify babies at the greatest risk of prematurity, because the causes of early labour are not yet fully understood.

Premature babies often have very low birthweights and their organs are not fully developed.

Sometimes the trauma of the birth means that very small babies do not survive the process.

If a woman has had one premature birth, the risk of the same thing happening in the next pregnancy is 15 per cent.