December 12, 2011
More Preemies Thrive With Modern Medical Advances
What do Rumaisa Rahmam, a healthy and normal first-grader and Madeline Mann, a college honors student have in common? Both are examples of extremely premature infants growing up to be normal, healthy, productive people.
Madeline, born in 1989, became the world´s smallest surviving baby at the time after she was born at Loyola University Medical Center, her birth weight was 9.9 oz., about the size of an iPhone. Rumaisa, born in 2004 came into the world even smaller at 9.2 oz.
Both have normal motor and language development, Loyola physicians wrote in a case report in Pediatrics, the official journal of the American Academy of Pediatrics, published online Dec. 12.
Most babies this small do poorly and many do not survive even with advanced medical care. “These are such extreme cases,” said Dr. Jonathan Muraskas of Loyola University Medical Center.
These children should not be considered the earliest that physicians can or cannot save all babies so small, reports Lindsey Tanner for the Boston Globe. Many extremely low-birth-weight preemies grow up with severe, lifelong disabilities such as cerebral palsy, mental retardation and blindness, or do not survive at all.
Neonatal care has advanced to allow the resuscitation and survival of even tinier newborns, Muraskas and colleagues wrote, suggesting that at the threshold of viability, three critical factors should be considered: gestational age, steroid treatment before birth and female gender, with gestational age playing the primary role in survivability, far more than the birth weight.
Both Rumaisa and Madeline required intensive medical intervention after being delivered by cesarean section more than a month early because their mothers had developed severe pre-eclampsia. Both children were attached to breathing and feeding machines and remained in the hospital for four months before being allowed to go home with their families.
As of last reporting, two years ago, Madeline has asthma and remains petite, 4´ 8” and about 65 pounds at the age of 20. Rumaisa at age 5 when last reported, weighed 33 pounds and was 3´ 6” tall, smaller than about 90 percent of her classmates, reports Tara Malone, for the Chicago Tribune.
Both “are thriving,” Muraskas said, with the girls and their families declining to comment for this story.
Madeline´s father. Jim Mann, said having a baby born so small was “terrifying” at first. But other than asthma, the only lasting effect his daughter has mentioned is having trouble finding age-appropriate clothes because she remains so small, he said. That she has done so well is a source of pride, and wonder. “I don´t know why, we were just extraordinarily lucky,” Mann said.
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