Resuscitation of premature newborns at 22–24 weeks in Iran: An ethical and clinical challenge: Editorial Article

Baghal Safa, Fatemeh; Taheri Bojd, Fatemeh

doi:10.66224/JBUMS.33.3.171

Volume 33, Issue 3 (9-2026) J Transl Med Res. 2026, 33(3): 171-174 | Back to browse issues page

‎ 10.66224/JBUMS.33.3.171

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Baghal Safa F, Taheri Bojd F. Resuscitation of premature newborns at 22–24 weeks in Iran: An ethical and clinical challenge: Editorial Article. , J Transl Med Res.. 2026; 33 (3) :171-174
URL: http://journal.bums.ac.ir/article-1-3627-en.html

Resuscitation of premature newborns at 22–24 weeks in Iran: An ethical and clinical challenge: Editorial Article

Fatemeh Baghal Safa ^*¹

, Fatemeh Taheri Bojd²

1- Neonatologist, Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , ftahery@yahoo.com
2- Department of Pediatrics, School of Medicine, Valiasr Hospital, Birjand University of Medical Sciences, Iran

Abstract: (548 Views)

Advances in perinatal care have lowered the threshold of viability to 22 weeks; however, the absence of a codified national protocol in Iran has resulted in subjective decision-making, inappropriate allocation of limited resources, and futile resuscitation. The fundamental gap in the health system is the lack of a national registry and disaggregated data on infants born before 28 weeks. International comparisons reveal striking differences; survival rates at 22 and 23 weeks in Japan have been reported at 60% and 80%, respectively, whereas rates in China and even across US centers remain highly variable and lower. Decisions should therefore be based on the tiered capabilities of each center and on three approaches: active resuscitation, palliative care, and shared decision-making. Gestational age alone is insufficient; birth weight, sex, 5-minute Apgar score, maternal complications, and particularly antenatal corticosteroid administration should be integrated into prognostic models. Antenatal referral to level 3 and 4 centers is of critical importance. Finally, establishing a national registry, developing a national clinical guideline, designing a localized risk calculator, and tiering centers with defined resuscitation eligibility are recommended.

Keywords: Ethical Challenge, Neonatal Palliative Care, Neonatal Resuscitation, Premature Infant

Full-Text [PDF 352 kb] (193 Downloads)

Type of Study: Editorial | Subject: Pediatrics
ePublished: 2026/09/23

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