ATLANTA — Doctors now have a better way of helping parents make an agonizing decision — whether to take heroic steps to save a very premature baby.
The number of weeks in the womb has generally been the chief factor. But a new study shows others are important, too — including whether the infant is a girl and whether the fetus gets lung-maturing steroids shortly before birth.
Those extra factors can count as much as an extra week of pregnancy.
The new information could change how doctors and parents decide what kind of care to provide to tiny, fragile, premature infants, said John Langer, a co-author of the study, which is being published this week in the New England Journal of Medicine.
Besides being a girl and getting the steroids, an extra 3 1/2 ounces or so of weight and being a single birth also helped as much as an extra week of pregnancy, the study found.
“For the first time, parents and their doctors will have the best available information on which to base one of the most difficult and time-sensitive decisions they are ever likely to face,” said Langer, who works in Maryland as a statistician for the North Carolina-based Research Triangle Institute.
Some parents of preemies said they’re not sure what they would have done with this new information had they had it at the time of birth.
Sean and Jolene Tuley of Mount Juliet, Tenn., were expecting twins when, in January, the placenta of one child — a boy named Ayden — detached from Jolene’s uterus. With no time to give the mother steroids, doctors performed an emergency cesarean section and delivered the children at 23 1/2 weeks.
A doctor told them the twins faced dangers and impairments — especially Ayden, who had a collapsed lung and serious brain bleeding.
“Do we continue treatment, or let him go?” recalled Sean Tuley.
The Tuleys instructed the doctor to keep providing care for both. Clara lived, and doctors think she may be able to go home from the hospital this week. But Ayden died after nine days.
It’s important that parents have all the information they can when facing a decision about care in a situation like that, said Jolene Tuley, 33.
But, she said, it’s not clear what parents can do about factors like whether the preemie is a boy or a girl or if the child had steroids.
“It’s not something you can control,” she said.
