Aiding difficult decisions

Sunday, April 20, 2008 | 2:05 a.m.

When babies are born three to four months prematurely, their chances of survival are uncertain, and parents often struggle with agonizing decisions on whether to aggressively treat these tiny infants with invasive and painful procedures.

Typically, parents and doctors have had little on which to base such decisions beyond an infant’s birth age and weight, which in the case of these babies are in the neighborhood of 22 to 25 weeks and 2.2 pounds.

About 40,000 such infants are born in the United States each year, The New York Times reports. If they survive, they often face severe brain damage or disabilities.

But researchers at the National Institute of Child Health and Human Development have developed an online calculator that could help give parents and doctors more information with which they can weigh their options, the Times reports.

The calculator estimates risks and possible outcomes based on data from a large study of such infants in similar conditions, which was published in the most recent edition of The New England Journal of Medicine. That study shows that certain characteristics give these tiniest of premature infants an advantage.

For example, girls typically fare better than boys of the same age, the study reports.

And infants who weigh more and are born as singles, rather than as twins or other multiples, are more likely to survive and avoid developing serious disabilities.

The calculator is not designed to make decisions for parents and doctors, Rosemary Higgins, the project’s leading researcher, told the Times. It is simply a tool for providing some solid information for parents as they make decisions that she described as “heart-wrenching and passionate.”

We would never want to see such a tool used as a way of measuring whether these tiny infants are worth the cost of their treatments.

But parents need all the information that is available to them when struggling to decide between subjecting their child to months of painful, aggressive care or offering the infant only the care that makes him comfortable until nature takes its course.