Littlest preemie now 15, story of medical success
Thursday, August 19, 2004
BOSTON -- Madeline Mann once weighed less than a can of soda as the tiniest surviving newborn known to medicine. Next week, she enters high school as something even more extraordinary -- an honor student who plays violin and likes to Rollerblade.
"Her survival wasn't a miracle; her development was," says Dr. Jonathan Muraskas of Loyola University Hospital in Maywood, Ill. He treated her as a newborn and reported on her progress today with other doctors in a letter to the New England Journal of Medicine.
At birth, she wasn't even pint-sized. Born 27 weeks into her mother's pregnancy, she weighed just 9.9 ounces, less than any surviving baby in medical history. She was just 10 inches long, smaller than a football and resting easily in a nurse's hand.
Yet several factors favored her survival. She was a girl, and premature girls tend to fare better than boys. Also, earlier preterm babies have survived, including some after only 22 weeks of pregnancy. Today, 90 percent of newborns survive after 27 weeks of pregnancy.
Survival, though, is just the first hurdle. Major handicaps like blindness and mental retardation are common in the survivors. Madeline, now 15, suffers from little worse than asthma. She is very small for her age, though, weighing 61 pounds and measuring 4-feet-7.
Her parents conceived her by artificial insemination. Her 36-year-old mother developed pre-eclampsia, a potentially dangerous condition that raised her blood pressure and squeezed the blood flow to the developing fetus. Doctors decided to perform a Caesarean section 13 weeks before her due date.
"I remember hearing the softest sound, almost like a kitten," says Robyn Leslie, her mother. "Then I realized it was Madeline crying."
She needed a breathing tube and oxygen in her early days. "Mechanically, you worry about if you're going to be able to get a tube into her little windpipe and trachea. Actually I had no problem," says Muraskas.
Over later years, she developed normally in nearly every way and never returned to a hospital bed except for pneumonia at age 4, delaying kindergarten by one year.
However, her doctors cautioned parents and others from viewing her as proof that a very premature baby will surely prosper with good medical care. Often, such children don't.
"These extremely low birth-weight, 'miracle' newborns can propagate false expectations," warned her doctors in their correspondence to the medical journal.
Now living outside Chicago, Madeline returned to Loyola Hospital last week for a belated 15th birthday party and a reunion with doctors and nurses. A blonde slip of a girl, she beamed a smile full of teeth and braces.
Her curriculum vitae otherwise reads much like any other teenager's. She likes to listen to music, chat with friends on the Internet, go camping and ride horses.
Last summer, she joined in a volunteer project giving out blankets to children with cancer. She has worked for a food pantry, visited with residents at a nursing home, and traveled to Michigan to rehabilitate houses.
"Madeline has overcome a lot of barriers," says her mother. "She has written her own story."
Her fairy-tale ending? She'd like to be a psychologist.
She'll probably have to learn about emotional and mental aberrations from a textbook, though. Her doctors and family says she's just a normal teen.