World’s tiniest infants doing fine now, but . . .
Two babies who rank among the smallest in the world are healthy and have normal motor and language development, researchers reported Monday. But the paper is not meant to celebrate the ability of high-tech neonatal medicine to save babies born midway through a normal pregnancy.
Instead, the authors note, severe prematurity often leads to death or disability. The babies whose fates are reviewed in the piece are exceptions.
Madeline Mann was born at Loyola University Medical Center in 1989 weighing 9.9 ounces. (The typical healthy baby is about seven pounds.) She is now a college student.
Rumaisa Rahman was born in 2004 at the same hospital weighing 9.2 ounces. She remains the world’s smallest surviving baby, and Madeline is the fourth-smallest surviving infant.
These children were luckier than most. Girls are more likely to survive than extremely premature boys, experts say. Moreover, the mothers of both babies were given steroids before birth -- in anticipation of a premature delivery -- to help the babies’ lungs and brains mature. Both mothers had high blood pressure.
Both babies spent months hospitalized after birth, however. They both remain small for their ages.
The issue of when to treat a baby born on the threshold of viability continues to plague neonatal medicine. Studies in recent years show most premature babies suffer some repercussions. Even babies born just a few weeks early have a higher risk of developmental disabilities.
Japan recently lowered its limit of viability to 22 weeks from the 24-week mark that most medical experts say is on the cusp of viability. In the United States, doctors say they struggle with the question of whether to “save” a baby born under 400 grams (about 14 ounces), which is considered non-viable -- because of the high chances that the child will be severely disabled and because of the enormous costs involved.
“Direct comparison between our two cases should be cautioned and can also propagate false expectations for families, caregivers, and the medicolegal community alike,” said the authors from Loyola University Medical Center.
The study appears Monday in the journal Pediatrics.
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