The National Catholic Bioethics Quarterly

Volume 14, Issue 3, Autumn 2014

Gestational Age in Periviable Newborns
An Insufficient Criterion for Deciding Intervention

When the delivery of a baby at the edge of viability (twenty-two to twenty-five weeks) is imminent, gestational age is usually the primary indi­cator for resuscitation. However, four other variables—female sex, antenatal corticosteroid therapy, singleton birth, and increased birth weight—are also associated with better infant survival and neurologic outcome in intensive care, and the combination of all five variables provides a stronger prognostic tool. An ethical framework is provided here for use in determining whether proposed treatments are likely to defend the dignity and sanctity of a fragile periviable life. The framework is based on the principle of ordinary/propor­tionate and extraordinary/disproportionate medical treatment. The author recommends using the most recent outcome data and this ethical framework together to make perinatal resuscitation decisions. Use of gestational age alone is insufficient and ethically immoral. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 429–439.