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Baby Chicks and Preemies
By Dave Andrusko
Among the most important
lessons I've learned in my life is that the more
you look around you, the more you will see.
That's hardly profound, unless you add that by
turning to the left and to the right instead of
staring straight ahead, you will be presented
with opportunities to help. Sometimes, as was
the case this morning, there will be little that
can be done.
My
middle daughter, Joanna, is the most sensitive,
caring human being I know. (She also is
possessed of the most uncanny ability to find a
four-leaf clover you will ever see.)
This morning her discovery
was, in the cosmic scheme of things, not that
big a deal. Except to her.
We were at the annual party
that our eldest daughter, a gifted teacher,
throws each year for her special needs students.
How she could have seen it is beyond me, but
while walking our dogs around the park, Jo
spotted this tiny two-three inch long baby bird
lying on the ground.
The chick had obviously fallen
out of its nest. It was so fragile there was
nothing we could do, although Jo tried for the
better part of an hour to figure out some way to
get the chick and its mother back together.
Although the bird was only
hours or days old with no chance of surviving,
knowing my daughter, that will be no
consolation. And while it may sound almost
ludicrous to say about a bird, in lieu of that,
Jo at least didn't want the chick to die
unattended.
I have often written in this
space how something that happens outside the
office will seamlessly link up to something I
subsequently encounter in my work as the editor
of this blog and National Right to Life News.
Sure enough, when I got to the office, as I
perused my stacks of emails, I ran across
several stories about a study on premature
babies coming out of Sweden.
Here are the first few
sentences of a story that appeared in HealthDay
News about the study which ran in the Journal of
the American Medical Association (JAMA):
"Advances in the care of
extremely premature infants mean that about 70
percent of these tiny newborns now survive their
first year of life, Swedish researchers report.
The number of preterm births is increasing
worldwide, and advances in perinatal medicine
have increased survival. That means that
neonatal intensive care can now be lifesaving
even for the most premature infants -- those
born between 22 and 26 weeks of gestation.
"The news is important, the
researchers said, because if parents and doctors
believe a preemie's chances for survival are
already slim, less aggressive care might be
extended."
Dr. Karel Marsal, a professor
of obstetrics and gynecology at Lund University,
was the lead researcher of the study published
in the June 3 issue of JAMA. The new results, he
said, suggest that the evaluation of "extremely
preterm babies should be done individually,
considering both the survival chances and the
morbidity risks." The survival rates "of
extremely preterm infants are high," he said,
"even at the borders of viability."
All infants born before 27
weeks gestation in Sweden during 2004-2007 were
the subject of the study. "Of the 707 live-born
infants, 70% were still alive at the end of the
year-long observation period of the study, which
is many more than have been previously reported
in studies," HealthDay News reported.
Now what's fascinating about
the study is that, depending on the news outlet,
the reader comes away either elated or with the
unmistakable message that it's still not
necessarily a good idea to aggressively treat
extreme preemies!
Obviously, babies born at 22
weeks are more likely not to survive than older
babies, and with more problems. For example,
only 10% of the Swedish babies born at 22 weeks
"survived to a year and only one of these
without any major illness," according to the
BBC." That's one "fact."
But consider that "In
comparison, 53% of those born at 23 weeks and
85% of those born at 26 weeks reached their
first birthday, and up to half of them without
serious illness." That's another fact. (And, by
the way, results at 23 weeks today will, in a
few years, likely be the same results for babies
then born at 22 weeks.)
Likewise, there were "104
deaths that occurred at least 24 hours after
admission to a neonatal intensive care unit."
But "42 (40%) involved a decision to withdraw
intensive care due to anticipated poor long-term
prognosis."
Put another way, certain
British medical authorities the BBC contacted
were concerned–-may I say obsessed–-with the
possibility that aggressive treatment might lead
to the survival of children with subsequent
disabilities. By contrast (as the BBC's account
explained), "Medical interventions did appear to
make a big difference to survival odds and
probably explain why Sweden had such an
impressive record. Babies born at hospitals with
the best intensive care facilities and expertise
and where active treatment was given--something
common-place in Sweden--were far more likely to
survive."
It really is a matter of
attitude and culture. Reading the stories, the
British medical personnel talked first and
foremost about costs and then mixed it up with
gloom-and-doom stories about premature babies
who survived.
By contrast, "We believe that
the good Swedish results are due to the
excellent collaboration between obstetricians
and neonatologists, a high degree of
centralization of very preterm deliveries to
tertiary level perinatal centers, and proactive
perinatal management," Marsal said.
I would end with this
question. In the hospitals of which country
would Joanna feel most at home?
Please send your comments to
daveandrusko@gmail.com. |