Slain Toronto woman's premature baby facing a tough road ahead, experts say
Police say the baby is about five months old and in stable condition, after being delivered by emergency c-section
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Not much is known about the tiny, premature baby lying in Sunnybrook hospital.
Police have only said that 35-year-old Candice Rochelle Bobb’s baby, delivered by emergency C-section about four months premature, is in stable condition.
Bobb was shot while sitting in the back of a car Sunday evening, and died from her injuries. But doctors were able to deliver her baby.
Neonatal experts, who track babies’ development by weeks, not months, say the baby faces a tough, but not impossible road ahead. In such situations, every week counts.
Andrew James, a staff neonatologist and interim head of division of neonatology at the Hospital for Sick Children in Toronto, who is not treating Bobb’s baby, said the bottom line is the baby is in the wrong place: outside of its mother.
“Babies born (at) less than 22 to 23 weeks don’t have a realistic shot of survival,” he added.
“That’s simply because of the biology of the lungs. The lungs are actually so immature that they cannot sustain life outside the uterus.”
In cases like this a baby’s chances come down to weighing probabilities, but every situation is different, he said.
According to statistics from the Canadian Neonatal Network, a baby born at 23 weeks has about a 25-per-cent chance of survival; a baby born at 24 weeks has about a 70-per-cent chance.
“Each baby is an individual in her own right. Some babies do a little bit better than the predicted probability and other babies do worse,” said James.
Doctors would have made the call to try to save the baby based on how far along they believed the pregnancy to be and how long the fetus had been without oxygen.
That’s a decision that would have been made “fairly quickly” and likely under “a backdrop of uncertainty” James said.
Once delivered, babies born this premature are typically treated in the Neonatal Intensive Care Unit (NICU), on average, until what would have been their due date. Doctors and nurses monitor the babies closely because they are at risk of infection due to their poorly developed immune systems.
Extremely premature babies are also at risk for long-term complications even if they make it through that first touch-and-go period, said Ashley Waddington, an assistant professor in the department of obstetrics and gynecology at Queen’s University’s medical school. These can include developmental delay, blindness and hearing impairment.
“Almost all of their organ systems are pretty underdeveloped,” said Waddington. “Premature babies do face a bit of an uphill battle.”
“Having said that, we’ve seen very good outcomes for babies who are born at 24 weeks, and we’ve seen, obviously, terrible outcomes for babies who are born that early.”
The youngest premature baby she has looked after who survived was around the 24-week mark, Waddington said.
Other factors, such as being born in a hospital with a good neonatal intensive care unit, can improve a baby’s chances, while being born in a traumatic situation where the mother is losing blood can impact the baby’s ability to get oxygen.
“(Bobb’s baby) has some things going for it and some things going against it,” said Waddington.
Dr. Salhab el Helou, a staff neonatologist at McMaster Children’s Hospital, said a baby born at around five months would “probably be between 500 and 600 grams in weight” and “less than 30 centimetres of length” and require a ventilator to breath.
But, he added, he has seen babies born prematurely at between 23 and 25 weeks survive and become healthy.
The smallest premature baby to ever survive at Hamilton Ontario’s McMaster University Medical Centre was born at 28 weeks, in October 2013. The baby weighed in at 330 grams, or just under 12 ounces, less than a can of pop.
Her head was about the size of a kiwi, and her father could fit his wedding band around her leg, according to a Hamilton Spectator article from that year.