When babies need to be delivered quickly, long before they are due, they often have a long road of recovery, if they survive at all, doctors say.
On Sunday, a pregnant woman was shot to death in the west end of Toronto. Her baby was delivered by emergency C-section, taken to a trauma centre in the city’s downtown, and is listed in critical but stable condition.
Police have said that Candice Rochelle Bobb was five months pregnant when she was killed, with many also reporting she was 20 weeks along in her pregnancy.
But Dr. Narendra Singh, the chief of staff at Humber River Hospital in Toronto, says that’s unlikely.
“Generally speaking, babies who are born at 20 weeks do not survive,” he told CTV News Channel Monday.
“When I heard about this case, my initial thought was that if the baby is in stable condition, it’s possible that the dates may be incorrect; so the baby may be closer to 22 or 23 weeks gestation.”
Singh says while the chances of survival at 20 weeks are almost zero, each week of gestation makes a big difference.
“The survival increases quite remarkably,” he said. “So if you look at the data across North America, the survival rate for babies at 22 weeks is about 35 per cent; at 23 weeks, it’s about 65 per cent.”
In this case, the baby may face further challenges if the mother’s heart had stopped before her baby had been delivered. If that was the case, there may not have been adequate oxygen-carrying blood going to the placenta and the baby.
No matter what the circumstances of birth, there are both immediate health concerns and issues down the road for extremely preterm babies.
“The immediate issues that babies will face is their lungs are immature, which is why they need to be on some sort of respiratory support -- often for an extended period of time until they can breathe on their own,” Singh said.
All babies born around 22 weeks gestation would need to be intubated and put on a respirator, and all would also be given a lung fluid called surfactant.
Natural surfactant production typically begins around a baby’s 24th week of gestation, acting as a grease in the lungs’ air sacs, or aveoli, to help them remain open and not stick together. Babies born before then need to have the chemical given to them through their intubation tube.
The second major risk such babies face, Singh says, is that of infection, which is a common cause of death in premature babies.
As well, their bowels are not adequately mature so they could also develop a condition call necrotizing enterocolitis, in which portions of their lower intestines simply begin to die.
Very premature babies are als oat risk of blindness from retinopathy of prematurity, a condition that causes abnormal blood vessels to grow in the retina.
“More importantly, if they do survive and they go home... a larger percentage of them – especially if they are born at 22 or 23 weeks – may have long-term neurological deficits that cause both physical and mental handicaps,” Singh said.
