Sweden ends intensive care for smallest premature babies

Sweden will no longer provide life-sustaining intensive care to infants born at 22 weeks of pregnancy, instead offering palliative treatment, according to new guidelines from the Swedish Medical Ethics Council. The decision, reported by Swedish public broadcaster SVT, marks a shift from the country’s previous practice of attempting to save such premature babies.

The change follows research showing high mortality and disability risks for infants born at 22 weeks, with survival odds improving significantly by week 23. In Finland, active intensive care typically begins at 23 weeks.

Finnish experts are divided on the decision. Liisa Lehtonen, professor of paediatrics at the University of Turku, expressed surprise, noting Sweden’s historical leadership in treating extremely premature infants. “Sweden has been a pioneer, and 22-week care is becoming more common globally, including in Germany, Japan, Canada, and parts of the US,” she said.

However, Marjo Metsäranta, head physician of the neonatal intensive care unit at Helsinki University Hospital (HUS), supported the move, stating it aligns with Finland’s current practice. “The risks of severe complications or death are very high at this stage,” she explained.

In Finland, treatment decisions often follow parental wishes. Between 2022–2024, 18 infants were born at 22 weeks in the country; ten received active care, and four survived.

Maija Miettinen, secretary-general of Finland’s Council for Social and Health Ethics, called Sweden’s decision understandable, noting it brings the country in line with most others. Swedish officials described the issue as ethically complex after prolonged debate.