Perhaps you’re facing a high-risk pregnancy, or you’re pregnant after a previous loss, and now you’re wondering: ‘What is the earliest a baby can be born and survive?’
If you are having difficulties in your pregnancy or possibly facing a premature birth, it’s understandable that you are constantly checking your calendar.
You might find yourself wishing the days would turn into week and the weeks quickly turn into months.
What’s the earliest a baby can be born and survive?
Like many women who face a high-risk pregnancy or experience anxiety, when you reach the 13th week of pregnancy you’ll feel a sense of relief. You’ve achieved the first big milestone and the risk of miscarriage is reduced.
After that, you might start to wonder at what week a baby can be born and survive. Certainly, no one hopes to have a premature birth.
If you’re facing a high-risk pregnancy, reaching a week when a baby can survive brings a little more relief.
And then, with every week that follows, you breathe a little easier, knowing the short and long-term odds improve with each passing day and week.
At what week in pregnancy can a baby survive outside the womb?
The earliest a baby has been born and survived is 21 weeks and 5 days. Two babies born prematurely hold the record for this.
Surprisingly, the first record holder was born in 1987, at a time when the medical care of premature babies (neonatology) was a very new field.
However, this is well before the accepted age of viability. Usually, the earliest a baby can survive is about 22 weeks gestation. The age of viability is 24 weeks.
For babies born at 22 weeks, there’s a 0-10% chance of survival; at 24 weeks the survival rate is 40-70%.
What does ‘age of viability’ mean?
What does it mean when a 22-week baby can survive but isn’t considered to be at the age of viability?
The age of viability for a premature baby is based upon a survival rate of at least 50%. This means there are good odds a baby can survive with medical support.
Although some 22- and 23-weekers do quite well, because fewer than 50% survive, the age of viability is still considered to be 24 weeks.
Some hospitals are not equipped to treat babies born early (before 24 weeks) and only offer palliative-type care.
In the US and many other countries, 24-week babies must be given treatment if they survive birth.
With advancements in medical technology, some experts are calling for more 22- and 23-weekers to be given a chance at survival.
Some believe the reason for such low survival rates is simply that these babies aren’t treated. For now, however, the age of viability remains at 24 weeks.
What is the survival rate at each gestational week?
There are many variables that come into play for individual preemies and their survival. The reason for prematurity – congenital conditions, prenatal care, etc. – can affect the outcome for a premature baby.
Current data shows the following rates for preterm babies at each gestation:
- 21 weeks or less: 0%
- 22 weeks: 0-10%
- 23 weeks: 10-35%
- 24 weeks: 40-70%
- 25 weeks: 50-80%
- 26 weeks: 80-90%
- 27 weeks: more than 90%
- 28 weeks: 92% or more
- 29 weeks: 95% or more
- 30 weeks: more than 95%
- 31 weeks: more than 95%
- 32 weeks: 98%
- 33 weeks: 98%
- 34 weeks: 98% or more.
For gestations under 24 weeks, some of the variations in percentages are due to different standards, or availability, of treatment for those born at these early gestations. Smaller community hospitals might not be equipped to handle very early preterm births.
If you’re facing a high-risk pregnancy, an important part of your care will involve doing some research into which hospitals have the highest level Neonatal Intensive Care Unit (NICU).
For more detailed information, week by week, be sure to read Premature Survival Rates By Week.
What’s the earliest a baby can be born and be healthy?
Babies born at 24 weeks have a high chance of survival but does this mean they will have long term health problems?
Many variables are involved; all of them have an impact on a premature baby’s short and long term health.
If babies are born early due to an infection or congenital health problem, they might be more likely to face complications, compared with babies who aren’t dealing with infection or other complications.
Prenatal care and treatment also play a role. If a woman is at obvious risk for preterm birth prior to 34 weeks, two steroid injections, given 24 hours apart, can greatly improve her baby’s lung development, to avoid respiratory distress syndrome.
Magnesium given via IV can also offer neuroprotection for infants born under 32-34 weeks gestation. Both steroid injections and magnesium can improve a baby’s short and long-term health. However, each baby is a unique individual.
In some cases, a newborn baby is given a dose of surfactant, which can help with breathing problems. A variety of other medications might be given to improve a baby’s immediate health and, in some cases, to improve long-term health.
For example, some babies are given caffeine to help treat apnea of prematurity. A recent study found that premature infants treated with caffeine in the NICU had improved lung function at age 11, compared with babies who were born prematurely and not treated with caffeine.
Statistically, the earlier the premature birth, the greater the risk of short and long-term complications. Some babies born at 22 to 23 weeks gestation have minimal health and developmental complications; others have severe health problems.
The same can also be said for late preterm babies, although the risk of severe complications is reduced with each passing week in pregnancy.
How do gestational age and size affect health?
Now that even the earliest premature babies can survive birth, we have more long-term statistics available. As previously stated, every baby is unique. Statistics simply give parents a better idea of what they might experience; they do not provide any guarantees.
Some current statistics show:
- 66% of babies under 1.25 kg developed retinopathy of prematurity (ROP), or vision problems, but only 6% required treatment
- About 25% of babies with a birth weight below 1.5 kg have hearing problems
- Children with an extremely low birth weight have more hospital admissions throughout childhood than those with typical birth weight. Respiratory illness is one of the most common reasons for admission
- One study found that in children aged 7-8, who were born before 32 weeks, 30% had a developmental delays, compared with 6% of children born at term
- Premature infants have higher rates of motor delays and, even if they have normal intelligence, it can affect how well they do at school.
You can read more about these statistics, including links to the studies mentioned, on the Patient website.
For pregnant women facing premature birth, this information can be very confronting. It’s important to remember, however, statistics provide us with information we can use to make informed choices and to be prepared.
What can be done to help a preterm baby?
Because we know a preterm baby is at risk for vision and hearing problems, examinations are done routinely. This is to make sure necessary treatment is given, to minimise risk, and so that therapies to manage effects can be started.
Because of the known risk of coordination and motor delays, and behavioral complications in premature babies, it’s important to work with early intervention programs and provide physical and occupational therapy, as soon as possible. This can reduce the risk of the infant experiencing delays or help manage and minimize their effects.
Neuroplasticity is an amazing thing. With proper treatment and therapy, underdeveloped or damaged brains can still do incredible things.
Many premature babies are a testament to early intervention. Their parents had been told of potential limitations but the children went on to exceed expectations.
Although statistics show a premature baby is at risk for health and behavioral complications, other studies show many premature babies do quite well. A recent study found that, by kindergarten age, most preemies were ready for school, just like their term peers.
Be sure to read Premature Babies – What To Expect Week By Week for more detailed information about each gestational week.
What do parents need to know?
It’s important to know that every baby is a unique individual. It’s also important to know that every pregnancy is unique. If you are high risk or have previously experienced a loss or preterm birth, it doesn’t mean you’ll have the same experience in future pregnancies.
The most important thing is to be sure you have adequate and regular prenatal care. If you’re at risk, or feel at risk, make sure you work with a provider you trust, and one with whom you can keep an open line of communication.
If you’re at risk of preterm birth due to high blood pressure, stalling or stopping labor is sometimes possible. This allows time for steroids, magnesium and other medications to improve the odds for you and your baby.
Always contact your midwife or doctor immediately, or head to the nearest hospital if you think you might be in labor.
For more information, you can read BellyBelly’s article: Signs Of Labour | Could l Be In Early Labour?
If you have a baby born prematurely, or you are likely to have one, there are many ways to help reduce the short and long-term risks.
Here are some things you can do:
- Know the signs of preterm labor
- Try to provide your baby with breast milk to improve short and long-term health, reduce the risk of infections, and improve cardiovascular health
- Use positive touch as early and as often as you can – in the NICU and when you go home. It is vital for helping brain development
- Practise kangaroo care to bond with your baby, improve development, help with milk supply and more
- Work with early intervention therapists. You can do this during the NICU stay (primarily through positioning and feeding skills) and after discharge. The earlier preterm infants work with necessary therapists (occupational, physical, speech, etc.) the better the outcome
- In the US, early intervention is provided through your state. Learn more on the CDC website, by clicking on your state
- In Australia, visit the ECIA website for more information.
It can be scary when a baby is born early. However, with today’s medical technology and an understanding of the importance of early learning support, many premature babies do quite well.