A new studyfrom Ohio State University — published in the Journal of the American Medical Association — shows births before 26 weeks of gestation now account for nearly 40% all neonatal deaths nationwide, and researchers fear that number could increase as states, like Ohio, enact abortion bans.
As part of the study, Dr. Kartik Venkatesh, Ohio State Wexner Medical Center maternal fetal medicine specialist, and his team, looked at data from the National Center for Health Statistics data for nearly 62,000 babies born at 22 to 26 weeks of gestation from 2014 to 2020.
Births that happen before 28 weeks are considered "periviable" or "extremely premature."
The data showed babies born in that time period account for four out of every 1,000 deliveries in the United States. But when it comes to neonatal deaths, Venkatesh said those babies represent nearly half of neonatal deaths.
“It's a problem because we know that it occurs more commonly in marginalized communities and in mothers of racial and ethnic minority communities of the United States, so it’s a real public health and clinical dilemma,” Venkatesh said.
Venkatesh said the interventions that can be done to help babies who are born at these earliest stages have been improving in recent years. But he noted infants born during this period to mothers of minority racial and ethnic groups, including Asian, Black and Hispanic mothers, were less likely to receive those medical intervention at birth, compared to white mothers.
"It's telling because more than half of the births in the periviable period actually occurred to minority women so they are over-represented in the sample, so much so that over a third of these births alone are occurring amongst Black mothers. So that's very concerning," Venkatesh said.
Venkatesh said every situation is different and changing abortion laws make it more complicated.
“In the coming years, it is possible we will experience an increase in periviable births, and at earlier gestational ages, in light of recent changes to laws governing reproductive freedom and choice,” Venkatesh said.
He noted even when these extremely premature infants survive, there is a high risk of potentially life-long adverse health outcomes for the child, including challenges with neurological function, intellectual development, behavior, and physical mobility.
He said those challenges often require a lot of treatment and care. And he said that could prove to be difficult for parents who lack resources to pay for it. He said more research into these disparities and resources will be needed to address them, especially now with stricter abortion laws in Ohio and elsewhere.
