Advances in medicine over the last 15 years now make it possible to save more preterm babies and guarantee them a much healthier future.
• Also read: Small miracles of medicine: a wonderful and tragic story at the same time
“Not only are they doing better in 2022, the majority of them are doing well! says dr Marc Beltempo, Associate Director of the Canadian Neonatal Network.
Each year in Quebec, more than 6,000 children (7%) are born prematurely, that is, at less than 37 weeks of gestation (out of an average of 40).
Of these, around 230 are born before the 25th week (“extreme” preterm birth). They weigh only 500 grams and fit in one hand.
This scenario is never what you hope for when you are expecting a child.
“This is the course nobody wants. It’s a nightmare. There are ups and downs,” says Ashley Cox, whose boy was born at 24 weeks (see additional text below).
But thanks to medical advances since the 1980s, these loved ones’ survival has improved by about a week every 10 years, multiple studies have shown. Today, half of babies born at 23 weeks will grow to adulthood, while ten years ago we saw that rate in Quebec for those at 24 weeks. Weight, gender, infant health: Several factors influence survival.
“They survive longer,” notes Dr. Christine Drolet, a neonatologist at Laval University Hospital Center. The pendulum swung down. »
life quality
Part of the explanation for this success is the 15-year knowledge sharing between Canada’s 30 centers specializing in preterm birth. Prenatal steroids, brain drugs, 30-second delay before cutting the umbilical cord: good practices have spread.
While they would like to save more newborns, doctors insist that babies born very prematurely (less than 32 weeks) are also healthier.
“The 24-week-old baby in 2022 is better off than the 25-week-old baby was 15 years ago,” explains Dr. Beltempo, a neonatologist at McGill University Health Center. You survive better. That is the big difference. »
“The goal is not to delight and save the smallest baby at all costs,” says Dr. drolet. It is to try that they survive but also that they have a good quality of life. »
Extremely premature babies risk all sorts of complications in the first week of life (cerebral hemorrhage, lung problems, etc.). Even if everything is fine, they will stay in the hospital for at least three months after the birth.
“We know the main complications,” assures Dr. drolet. But there is always a part where we have no control, even if everything is done according to the rules of the art. »
Are we saving him or not?
Today, the breakeven point is 24 weeks. Prior to this, the parents are included in the conversation to decide whether or not to resuscitate the child.
“It’s hard to draw an arbitrary black or white line,” says Dr. belt speed. Depending on family values, there may be different views. »
Despite all these advances, premature babies are at higher risk for various health problems (lungs, heart, cerebral palsy, etc.)
And although medicine will one day reach its survival limit, physicians are confident they can continue to improve their practice.
“We wouldn’t do this if we didn’t think they would have a good quality of life. The majority will function normally,” swears Dr. belt speed.
Survival rate of very preterm infants
- 23 weeks: 50%*
- 24 weeks: 70%
- 25 weeks: 85%
- 26 weeks: 90%
*These numbers are approximate and depend on several factors
RELATED LONG TERM EFFECTS
- speech delays
- Attention Deficit Hyperactivity Disorder
- Motor or intellectual development
- Deafness or sight (0.01% in Canada)
FACTORS THAT INCREASE THE RISK OF PREMATURE
- Mothers under 20 or over 45
- multiple pregnancies
- mother with lower educational level
- Low socioeconomic status
- gestational diabetes
- pre-eclampsia
Sources: Canadian Neonatal Network and National Institute of Public Health of Quebec
I hope to go home within a month
After a rushed delivery at 24 weeks and 2 days gestation in May, little Ezekiel’s parents are finally starting to plan for a future at home, away from the constantly ringing machines.
“We would have loved to introduce him to our family like everyone else does with their baby,” admits Ashley Cox, 33, who she recently met in the NICU at Montreal Children’s Hospital.
“But for a week or two, we feel like he’s coming home. We can’t wait to wake up one day and have him next to us,” she says, cradling her baby doll.
There is no doubt that little Ezekiel was eagerly awaited by his parents, who had suffered three miscarriages. His arrival on May 23, however, plunged them into a whirlwind of fear.
The boy should still not be born; the due date was September 11th.
At birth, the baby weighed only 710 grams. The delivery went well, but the parents feared for their lives on several occasions.
“As soon as there was a beep, we panicked,” recalls Ms. Cox, who turns to the monitors as the numbers take over.
At his bed
Urinary tract infection, lumbar puncture, contact with COVID-19: the first few weeks were tough.
Since Ezekiel was in the hospital, his mother spends 12 hours a day at his bedside and returns home at night. His father also comes after work.
“These are things that normal people don’t experience in their lives,” Ms. Cox compares.
His weight tripled
Recently, the infant no longer needs a machine to help him breathe, suggesting a return home within a month. Force-fed since birth, he has to learn to drink from a bottle.
Despite the fears surrounding his premature birth, his mother is now confident about the future of her son, who has been gaining weight since birth.
“The way he’s acting, we’re less scared,” she said. When we take care of him, his eyes are open, he looks everywhere. »
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