In the United States, 30,000 babies are born every year at 26 weeks gestation or less. This extreme prematurity is the nation’s leading cause of infant mortality (death) and morbidity (sickness). Fewer than half survive. Of those who do, 90 percent suffer sickness and disability, such as lung disease, cerebral palsy, blindness and brain damage. The annual cost of hospital care for these babies is estimated at more than $40 billion.

Surgeons and neonatologists at Children’s Hospital of Philadelphia witness the effects of prematurity every day. And now a team of them has innovated a system that could revolutionize care for these tiny and vulnerable babies.

The device — which is in an experimental stage using animal models — replicates the womb. The fetuses remain immersed in fluid and their lungs are kept at rest.

The results, published in April in Nature Communications, show great promise. The research team, led by surgeon Alan Flake, MD, Director of the Center for Fetal Research at CHOP, is currently working to scale down the system for use in human infants, who are much smaller than infant lambs.

“If our system is as successful as we think it can be, ultimately the majority of pregnancies predicted at-risk for extreme prematurity would be delivered onto an system that keeps them immersed, rather than being delivered onto a ventilator,” says Flake. “With that we would have normal physiologic development and avoid essentially all of the major risks of prematurity — and that would translate into a huge impact on pediatric health.”