A small number of very premature babies are surviving earlier outside the womb than doctors once thought possible, a new study has documented, raising questions about how aggressively they should be treated and posing implications for the debate about abortion.
 
一项新研究提出证据表明，少数极度早产儿能在子宫外存活，而医生过去认为这是不可能的。这一发现提出了究竟应该怎样努力护理这些早产儿的问题，也可能会影响有关堕胎的争论。

The study, of thousands of premature births, found that a tiny minority of babies born at 22 weeks who were medically treated survived with few health problems, although the vast majority died or suffered serious health issues. Leading medical groups had already been discussing whether to lower the consensus on the age of viability, now cited by most medical experts as 24 weeks.

这项对数千早产儿的研究发现，极少数在妊娠22周时出生的婴儿，经过医疗护理后存活了下来，而且几乎没有影响他们健康的后遗症。虽然绝大多数如此早产的婴儿死亡，或有严重的健康问题。一些知名的医学团体已经在讨论是否要降低公认的可独立存活胎龄，目前绝大多数医学专家引用的是24周。

研究发现22周早产儿有机会存活

The Supreme Court has said that states must allow abortion if a fetus is not viable outside the womb, and changing that standard could therefore raise questions about when abortion is legal.

美国最高法院曾表示，如果胎儿不能在子宫外存活，各州必须允许堕胎。因此改变可独立存活胎龄的标准可能会催生何时堕胎合法的问题。

For most parents and doctors, the new study will intensify the agonizing choices faced about how intensively to treat such infants.

对于大多数家长和医生来说，新研究将使他们面临的究竟要在多大程度上特别护理这些婴儿的选择变得更加艰难。

The study, one of the largest and most systematic examinations of care for very premature infants, found that hospitals with sophisticated neonatal units varied widely in their approach to 22-week-olds, ranging from a few that offer no active medical treatment to a handful that assertively treat most cases with measures like ventilation, intubation and surfactant to improve the functioning of babies’ lungs.

这项研究是对极度早产儿护理的最大范围也是最系统的考察之一。研究发现，有先进新生儿病房的医院在对22周出生婴儿的护理方法上差异很大。有为数不多的医院不提供任何积极的医疗护理，也有极少数的医院果断地治疗大多数早产儿，对他们使用呼吸机、气管插管，以及表面活性剂来提高婴儿的肺部功能等措施。

“It confirms that if you don’t do anything, these babies will not make it, and if you do something, some of them will make it,” said Dr. David Burchfield, the chief of neonatology at the University of Florida, who was not involved in the research. “Many who have survived have survived with severe handicaps.”

“研究证实，如果你什么都不做，这些早产儿不可能活，而如果你做点什么，其中一些能活下来，”佛罗里达大学新生儿科主任医生大卫·伯奇菲尔德博士(Dr. David Burchfield)说，“但许多活下来的早产儿有严重的身体障碍。”伯奇菲尔德博士没有参与这项研究。

Results of the study, published Wednesday in The New England Journal of Medicine, are likely to influence a discussion taking place among professional medical associations about how to counsel parents and when to offer treatment to such tiny babies.

该研究的结果周三发表在《新英格兰医学杂志》(The New England Journal of Medicine)上，很可能会影响专业医学协会就如何为家长提供咨询、以及在什么情况下该对这些特别早产的婴儿提供医疗护理的问题所进行的讨论。

The study, involving nearly 5,000 babies born between 22 and 27 weeks gestation, found that 22-week-old babies did not survive without medical intervention. In the 78 cases where active treatment was given, 18 survived, and by the time they were young toddlers, seven of those did not have moderate or severe impairments. Six had serious problems such as blindness, deafness or severe cerebral palsy.

这项研究涉及近5000名在妊娠22周到27周出生的婴儿，研究发现，22周出生的婴儿在没有医疗干预的情况下不能生存。在进行了积极治疗的78个病例中，有18个活了下来。他们长到两、三岁时，有七人没有中度或重度身体障碍，有六人有严重的问题，如失明、失聪或严重脑瘫。