Module232025

07/05/2025

Neonates and Premature Babies – facts

• The neonatal period is the first 4 weeks of a child's life • A baby born at 24 weeks gestation is a neonate for 20 weeks • A normal pregnancy typically lasts around 40 weeks • A baby born between 37 and 42 weeks is considered full-term (survival almost 100%) • A baby born between 28 and 37 weeks is considered premature (survival >90%) • A baby born between 24 and 28 weeks is considered extremely preterm (survival 60-90%) • A baby born before 24 weeks has a 15% survival • The limit of foetal viability is generally considered to be around 22 to 24 weeks. International consensus that that 22 +6 weeks is the cut–off of human viability, but….. Boghossian, N.S. et al (2025). Active Treatment and Survival Trends for Periviable Births by Race and Ethnicity. JAMA. Published online April 26, 2025. doi:10.1001/jama.2025.3033. Survival rates among infants born at 23 weeks between 2014-2023 who received active treatment went up from 54% to 58%.

Common Diagnoses in the NICU Amenable to medical treatment

The current world record for the lowest gestational age newborn to survive is held by Curtis Zy-Keith Means, who was born on 5 July 2020 in the United States, at 21 +1 weeks weighing 420 grams (15oz, so less than 1lb) .

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Neonates and Premature Babies – challenges - 1

Neonates and premature babies share a number of challenges for drug and device development • Small physical size – attaching measuring devices can be difficult • Low blood volumes Normal birth weight is 2-5-4kg, with a blood volume of 188-300mL The EU 24-hr blood sample limit is 1% of TBV which means 1.8-3mL for a full-term baby Curtis had a TBV or ~63mL, so his blood sample limit would have been 0.6mL in the EU, but 1.5mL in the USA Samples required for clinical purposes – often little room for research samples • “Patients must feel better or live longer” – can only assess live longer in these groups

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