KANSAS CITY, Mo. – It's good news for the tiniest and most vulnerable among us. Thanks to changes in care practices and other advances, survival rates for extreme preterm infants – sometimes called "micro preemies" – are on the rise.

The study from the National Institutes of Health research network examined the cases of more than 34,000 babies over two decades, born between 22 and 28 weeks gestation at facilities across the country, including Children's Mercy. Between 2009 and 2012, survival rates for babies born at 23 weeks increased from 27 percent to 33 percent, which Children's Mercy pediatric neonatologist Dr. William Truog calls "promising."

"There is continuing reason for optimism for these children," he says. "At the same time, we know that being born with this degree of prematurity that the course is long, difficult, and the risk of long-term developmental problems is still substantially higher."

Truog, one of the co-authors of the study, says standardizing certain practices, like giving a mother in early labor a short course of steroids to boost the baby's lungs, has been a significant factor. According to the CDC, about 11 percent of babies in the U.S. are born preterm, or before 37 weeks. Of those, about one percent are born before 28 weeks.

Truog says that equates to roughly one in every 100 births, a rate he says is nearly twice as high as some other developed countries. He stresses that while modern medicine has made great strides toward treating extremely premature infants, there is simply no substitute for a healthy full-term pregnancy.

"Every week or two that a baby can stay in the womb safely by stopping or delaying labor, just confers a huge survival advantage week by week," he says.

The study appears in the online edition of the Journal of the American Medical Association.


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New Hampshire ranks second in the country on measures of child well-being, according to the new 2022 Kids Count Data Book from the Annie E. Casey Foundation.

The Granite State scores well for economic well-being, education, health, and family and community factors. However, researchers also found rising rates of attempted suicide nationally, especially for students of color or LGBTQ youths.

In New Hampshire, said Emma Sevigny, children's behavioral health policy coordinator with New Futures, a health advocacy nonprofit in Concord, said the new 988 mental-health hotline is paired with local crisis-intervention services.

"And with it, we have a rapid response team that's available to give support to kids in their communities," she said, "so if we can improve that system and ensure that there is sustainable funding for it, that's a huge step in the right direction."

The report ranked New Hampshire fourth in education, but it drops to seventh for the number of 3- and 4-year-olds not attending preschool. Sevigny said she would like to see more subsidies to help parents afford preschool.

Leslie Boissiere, vice president for external affairs at the Annie E. Casey Foundation, said she'd like to see Congress renew the extended Child Tax Credit that boosted the bottom line for low-income families during the pandemic, but was allowed to expire.

"It's incredibly important that decisionmakers seize the opportunity and the lessons learned during the COVID-19 period, when more resources were provided to families, so that we can make sure that every child has their basic needs met," she said, "that fewer children live in poverty, and that the overall well-being of children in this country increases."

In the legislative session next year, state lawmakers will decide whether to reauthorize the expansion of Medicaid, a lifeline for many struggling families.

Massachusetts ranks first in the nation for children's well-being, according to the 2022 Kids Count Data Book from the Annie E. Casey Foundation.

Experts gave the Bay State high marks for combating poverty and boosting educational achievement. However, the report also found an increase of more than 50% in children ages 3 to 17 with anxiety or depression between 2016 and 2020, nearly double the national average.

Mary McGeown, executive director of the Massachusetts Society for the Prevention of Cruelty to Children, said the state faces a shortage of inpatient psychiatric beds.

"On any given day there are hundreds of kids who need inpatient care, who have gone to an emergency room seeking help," she said, "and they wait there days, weeks, and sometimes months for access to a bed."

Gov. Charlie Baker signed a comprehensive mental-health bill Wednesday that sets up a dashboard to manage psychiatric beds, invests in school-based behavioral health and more.

McGeown credited Massachusetts' top overall score to its success in getting almost all children covered by health insurance, as well as targeted supports to schools and low-income families during the pandemic.

Leslie Boissiere, vice president for external affairs at the Annie E. Casey Foundation, said the nation's recovery remains very uneven, with continued economic hardship, both in highly urban and rural areas.

"Enacting policies that we know can lift children out of poverty and also can secure the financial security of low-income families," she said. "Things like expansion of the Child Tax Credit. Putting resources in the hands of low-income families, so that they can provide for the basic needs of their children."

The report recommends expanding the Earned Income Tax Credit, which provides cash supports to low-income families.

Minnesota once again gets a high ranking among states for child well-being, but an annual report says the state's disparities remain a challenge, with marginalized families seeing lasting impacts from the pandemic.

This year's Annie E Casey Foundation Kids Count Data Book focuses on concerning mental health trends that have surfaced around the country. Nine percent of high schoolers overall reported attempting suicide in the most recent data year, along with 12% of Black students.

Deb Fitzpatrick, director of policy and research for Children's Defense Fund Minnesota, said these disparities are being seen within the state.

"This isn't just going to solve itself because the pandemic is in the rearview mirror for many people," she said. "We know that we had some challenges before the pandemic, and we're going to continue to see those going forward."

Fitzpatrick said issues such as economic stability and mental health go hand-in-hand, and in families that lost income during the pandemic, the children are likely to experience added stress. Overall, Minnesota ranked third in the report, and landed in the top ten for such categories as economic well-being, education and health.

State leaders did make some mental-health investments in the recent legislative session. But advocates have said more can be done to help kids, with a large surplus still available. The Casey Foundation's vice president for external affairs, Leslie Boissiere, added that federal policymakers could help by looking at past successes.

"The expansion of the Child Tax Credit lifted millions of children out of poverty," she said. "When policymakers enact policies that we know lift families out of poverty, then children do well."

The temporary expansion of the credit, which included monthly payments, expired at the start of the year. There have been calls to make it permanent, but partisan gridlock in Congress has prevented that from happening.