The rules governing which South Carolina hospitals are allowed to treat the state's smallest newborn babies will likely change next year, but the updated regulations may not do Trident Medical Center much good.

The North Charleston hospital asked the state health department for permission to upgrade its nursery so that doctors there can take care of infants who weigh less than 3.3 pounds. Current regulations prohibit the project because the medical center is located within 60 miles of Medical University Hospital - one of a few hospitals designated by the state to treat the smallest, sickest newborns. Trident's request for an exception to this rule was denied earlier this year.

Many experts believe that limiting the number of hospitals allowed to treat very premature infants concentrates expertise and improves outcomes. Others say evidence to support this claim is outdated.

Proposed changes to the hospital regulations, which were granted initial approval by the S.C. Department of Health and Environmental Control board on Thursday, scrap the 60-mile rule and replace it with a volume requirement. If the proposed changes are approved by the Legislature next year, Trident would need to prove that it treats an average 100 "very low-birthweight babies" - defined as those who are born weighing less than 1,500 grams, or about 3.3 pounds - every year to proceed with its nursery upgrade.

"It creates somewhat of a 'Catch 22' for us," said Dr. Art Shepard, a Trident neonatologist who spoke to the DHEC board Thursday. "How can we ever accumulate 100 cases of something that we're specifically prohibited from treating?"

Trident Medical Center only treats an average 75 very low-birthweight babies every year, he said. Many of those infants are eventually transferred to Medical University Hospital, despite the fact that Trident neonatalogists are capable of providing high-quality care, he said.

Shepard argued before the board that the new regulations merely exchange the 60-mile rule with another seemingly arbitary requirement.

But DHEC Director Catherine Templeton said the proposed changes are based on research, not whim.

"The 100 number has its basis in studies," she said.

Representatives for the March of Dimes, the South Carolina Perinatal Association and MUSC spoke in favor of the proposed regulations at the meeting in Columbia on Thursday.

The new rules may tentatively take effect in May 2015, pending approval by the General Assembly, Templeton said.

Reach Lauren Sausser at 937-5598.