World's Smallest Babies Go Home from Hospital


Two of the smallest babies ever to survive have recently been released from hospital, one in America, and the other in Japan.


Saybie weighed 245 grams (8.6 ounces) when she was born in December at Sharp Mary Birch Hospital for Women and Newborns in San Diego. She is believed to have broken the record for the world’s tiniest baby, according to the Tiniest Babies Registry.


The previous smallest baby was discharged from Nagano Children’s Hospital in central Japan only days earlier. The baby boy was born in a clinic in the Japanese city of Keio weighing just 268 grams.


When Ryusuke was born on October 1, 2018, he measured 22 centimetres (8.66 inches) tall, and the medical staff kept him in a neonatal intensive care unit. He was delivered at just 24 weeks and five days of pregnancy after he stopped growing inside his mother’s womb due to her hypertension. Medical staff used tubes to feed him, sometimes taking cotton swabs to apply his mother’s milk to his mouth.


The physician in charge of caring for Ryusuke, Dr Takahashi Arimitsu, said that this case shows that “there is a possibility that these children will be able to leave the hospital in good health even though they are born small”. The baby did not suffer any negative medical sequelae on discharge.


The record for the most premature baby boy to survive before Ryusuke was one born in Germany in 2009 weighing 274 grams. The previous tiniest baby girl was also born in Germany, in 2015, and weighed 252 grams.


A recent article published in Medical Express describes how survival rates for extremely preterm infants have improved by leaps and bounds since the 1980s, with recent US and Swedish studies providing new data on the trend.


Doctors previously estimated the earliest gestational age a baby could be considered viable outside the womb was 28 weeks, when they weigh around 2.2 pounds (one kilogram)—about 12 weeks short of the 40-week length of a normal pregnancy. Babies are considered premature under the 37-week mark. But over the last nearly 40 years, that 28-week limit has steadily dropped, and now some babies delivered at 24, 23 or even 22 weeks are able to survive, even as they weigh 1.1 pounds or less.


Sweden holds the world record for earliest neonatal viability: 77 per cent of babies born between 22 and 26 weeks in 2014 to 2016 survived one year, up from 70 per cent about 10 years before, according to a study published in the Journal of the American Medical Association (JAMA).


Nearly 90 per cent of deliveries in Sweden now occur in one of six hospitals in the country that have top-level neonatal intensive care units.


“Before, for a baby born at 22 or 23 weeks, an individual doctor could say that it is not worthwhile to do anything,” said Mikael Norman, co-author of the Swedish study and a neonatologist at Karolinska University Hospital in Stockholm.


For infants younger than 22 weeks, the survival rate has improved from 3.6 per cent to 20 per cent over the last decade, and for those born at 26 weeks, eight in 10 survive.” (Medical Express, April 19 2019).

Bioethics Observatory. May 22. RTÉ. May 30.

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