Survival of Infants Born at/after 22 Weeks has Significantly Improved

Advocating for neonatology presence at births between 20 and 25 weeks of gestation

Survival for infants born at 22 weeks has improved dramatically when active care is offered as shown in a recent JAMA article. 22 weeks is now the new threshold for viability. Not 23 or 24 weeks. Yet many hospitals still fail to require neonatal team attendance at these births. Our prior article (PMID: 39448333) urges institutions to end this harmful gap in care and reommend neonatalogists, if available, from 20 weeks of gestation onwards to ensure gestation calculations were not missed. Neonatologists should be present to assess, intervene, and guide families through these high-stakes moments. Hospitals with available neonatal services should recommend a neonatologist’s attendance at births from 20 weeks onward—not simply defer to “shared decision-making.” This ensures that families receive expert input before essential decisions are being made, not after outcomes are irreversible. Hospitals that neglect this are failing both science and ethics.
Healthcare institutions must recognize the evolving landscape of neonatal care and the evidence supporting early intervention. By ensuring neonatology teams are present at births from 22 weeks gestation, hospitals can provide comprehensive care that aligns with current medical standards and ethical obligations.

Advocating for neonatology presence at births between 20 and 25 weeks of gestation:

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