Preterm Infant Survival Rates Stalling, Or Getting Worse, Study Warns

Despite efforts to improve the survival rates of premature infants, and decades of improvements in reducing fatalities, the findings of a new study suggest that the rates have leveled off in recent years, and deaths associated with certain conditions are actually rising.

In a report published this month in the medical journal Pediatrics, researchers found that premature infants are still less likely to die of sepsis and retinopathy than in previous years. However, improvements in long-term outcomes for some conditions have leveled off, such as necrotizing enterocolitis and severe intraventricular hemorrhage, and rates of preemies dying due to chronic lung disease have increase.

Researchers from the University of Vermont used data from the Vermont Oxford Network members on infants born in the United States at 24 to 28 weeks pregnancy from 1997 to 2021. The data included information for more than 447,000 infants at 888 hospitals. They looked at rates of overall mortality, sepsis, chronic lung disease, severe intraventricular hemorrhage, necrotizing enterocolitis, severe retinopathy of prematurity, and death or morbidity.

Overall, the data indicated death rates and illness rates for preterm infants decreased significantly several decades ago, but those decreases have stalled in recent years, indicating an increase in premature infant deaths may be possible in the future.

According to the findings, from 2005 to 2021, premature infant death rates decreased significantly but began to slow in 2012. Similarly, rates of late-onset sepsis among preterm infants decreased from 1997 to 2021, but the rate of decrease began to slow in 2012 and continued until recently.

Conversely, rates of chronic lung disease among preterm infants have increased since 2012. Necrotizing enterocolitis, severe intraventricular hemorrhage, and death or morbidity decreased in prior years, but have remained stable since 2015.

Severe retinopathy of prematurity decreased from 2002 to 2021, but those decreases have slowed significantly since 2011.

Preterm Birth Risks

Infants born before 37 weeks of pregnancy are considered preterm. Infants born before 28 weeks of pregnancy or before the 7th month of pregnancy are considered very preterm.

Preterm infants can experience a range of health side effects, including breathing problems, cerebral palsy, digestive issues, heart conditions, infections, difficulty regulating body temperature, and difficulty feeding.

They can also suffer lifelong health effects such as mental retardation, cerebral palsy, and visual and hearing impairment.

The United States has one of the highest maternal death rates of any wealthy or developed nation in the world. And the maternal death rate increased significantly in 2021, especially among women of color.

The findings of the new study may indicate death rates for mothers are not only increasing but may be increasing among preterm infants in future years as well.

And, despite changes to help improve the maternal death rate, birth complications affecting infants are also on the rise.

“Improvements in mortality and morbidity have slowed, stalled, or reversed in recent years,” the researchers of this latest study concluded. “We propose a 3-part strategy to regain the pace of improvement: research; quality improvement; and follow through, practicing social as well as technical medicine to improve the health and well-being of infants and families.”