Birth of your baby at 23 to 25 weeks

This contains information about the issues and decisions you may need to consider if your baby is born very early. This can be an extremely emotional time and our staff are here to support you. The doctors involved in your care include obstetricians and paediatricians, who are experts on managing extremely preterm birth, and they will explain your individual situation and help you make decisions about your baby’s care.

Please note: This document should only be used in association with a consultation from a neonatal paediatrician. Information is for pregnancies of 23 weeks and over. If your pregnancy is less than 23 weeks, please speak to your doctor for more information.

Survival of babies born early

Your baby’s chances of long-term survival are greatly increased the longer you are pregnant.

Not all babies born at 23 to 25 weeks gestation (15 to 17 weeks early) are able to survive the birth process and resuscitation in the delivery room or operating theatre. Babies who do survive will get admitted the Neonatal Intensive Care Unit (NICU).

The survival rate for babies who get admitted to the NICU is approximately 60 per cent at 23 weeks, rising to 80 per cent at 24 to 25 weeks.

Disabilities in babies born early

Babies born early are more likely to have disabilities than babies who are born at term (40 weeks).

The table below shows the percentage of babies born at King Edward Memorial Hospital (KEMH) between 23 and 25 weeks who have a disability.

The range and degree of disability varies greatly and includes mild disability, such as significant learning problems and mild issues with motor skills and co-ordination, through to severe disability including cerebral palsy, blindness, deafness and intellectual disability. Severe disability usually means not being independent as an adult.

Hospital guidelines

At 23 weeks gestation (17 weeks early)

Individual circumstances vary widely, and you and your doctors will make the best decision regarding your baby’s resuscitation and care. Often, babies at 23 weeks gestation are able to be resuscitated and admitted to the NICU. Sometimes, despite all our efforts to keep them alive, very premature babies do not survive. You will be able to talk to your doctors about your baby’s care and any concerns you may have.

At 24 weeks gestation (16 weeks early)

Although these babies are often very sick, intensive care treatment is usually given because survival rates are good.

At 25 weeks gestation (15 weeks early)

While still very early, most babies at this gestation do survive and intensive care is always provided.

Support available

The Social Work Department at KEMH or Perth Children’s Hospital (PCH) can provide you with information and practical support while you and/or your baby are in hospital.

Pastoral Care Services at KEMH and PCH provide emotional and spiritual support to families with babies in the NICU.

Outcomes

The earlier a baby is born, their risk of having a disability is increased. Disabilities in children may not be noticed until they are several years old. Despite many tests, your doctor may not know early whether your baby will develop problems.

Problems may include cerebral palsy, which means a disability that varies from mild problems with motor skills and coordination (common) to not being able to walk and needing a wheelchair (uncommon).

Learning difficulties are very common in children born extremely preterm. These may range from mild developmental delay (common) to severe intellectual disability (uncommon). Delay in speech development is common in children born very preterm. Children born extremely preterm have an increased risk of behavioural problems.

Although blindness is a very severe disability, it is fortunately extremely uncommon in very preterm babies born in Western Australia.

Problems with hearing and needing to wear a hearing aid is not common but can sometimes occur in preterm babies. After they go home, most preterm babies are healthy. We have a long-term follow-up program in place to regularly check and support these babies and their families.

A small number of babies have ongoing medical needs and these babies will be referred to PCH for treatment.