economics Paradigm Challenge

Most baby doctors now think we should deliver some babies early just so we can start life-saving gene therapy immediately.

March 18, 2026

Original Paper

Elective preterm delivery to initiate therapy for spinal muscular atrophy and genetic diseases with antenatal pathology

Richard S. Finkel, Kelsey C. Lewis, Ajay J. Talati, Eugenio Maria Mercuri

SSRN · 6318907

The Takeaway

For diseases like Spinal Muscular Atrophy, irreversible damage can occur before a baby is born full-term. Doctors are now seriously debating 'elective prematurity' as a standard clinical path, prioritizing early access to powerful new gene therapies over the known health risks of being born too soon.

From the abstract

Objectives: Some genetic diseases have the onset of irreversible pathology in utero, rendering post-natal initiation of a disease monitoring therapy (DMT) sub-optimal. A survey was conducted to identify neonatologists’ opinions on the hypothesis that prompting an elective premature delivery of a fetus in this setting, such as spinal muscular atrophy (SMA), to enable initiation of a DMT earlier in gestation is appropriate.   Methods: A ten-item survey was constructed. Responses were obtained from