Am J Perinatol 2019; 36(S 02): S1-S3
DOI: 10.1055/s-0039-1691768
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Amazing Premature Lung

Alan H. Jobe
1  Division of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
25 June 2019 (online)

The lung is often the weak link (organ) that limits survival of the extremely premature infant because the lung must function for gas exchange immediately after birth and then for many months of neonatal care until maturity. The infant with 24-week gestation has developed for only 22 weeks or 58% of a 38-week-term gestation, with subtraction of the 2 weeks from last menstrual period to conception used to calculate a normal 40-week-term gestation. Survival of infants with 24-week gestation is now common, and infants as early as 22 weeks of gestation are now at the margins of viability (20 weeks of a 38-week gestation = 53% of gestation). As normal lung maturation defined as normal gas exchange at birth occurs at approximately 36 weeks (34 weeks from conception), these very preterm lungs can support survival 3 to 4 months prior to normal lung maturation with help from the modern tools of neonatology. Multiple elements of lung development, injury, and repair contribute to this quite remarkable survival potential for the very preterm infant.