Premature babies are everywhere. Eighty per cent of them, according to a new study, are left with a mental or physical problem, a cost far worse than was previously thought. But these babies are the tiniest infants who can possibly survive early birth, those born before 23 weeksâ€™ gestation. A premature baby, though, is defined as any who emerges before the 37th week of pregnancy. Only a small proportion are born at 28 weeks or more. They are almost always old enough to survive; but are they old enough to escape unscathed, or is there a legacy for them, too? Like most mothers of premature babies, I have always suspected that there is a legacy. Nearly 13 years ago, my daughter Rosie was born at 29 weeks. I always realised her early life had been very different from what nature intended: but it wasnâ€™t until I could compare it with the â€œnormalâ€™â€™ arrivals of her three younger sisters that I began to understand quite how different it had been.
Whereas my younger children emerged plump and alert from the safety of a womb that had nudged them out when it had done its job, Rosie was plucked skinny and sleepy from a uterus that intended â€” had pre-eclampsia and the surgeonâ€™s knife not intervened â€” to hold on to her for a good while yet. Whereas my later babies spent their early weeks attached to a breast, cuddled in my arms or lying within earshot, Rosie spent her first few weeks in a plastic box with little in the way of physical contact from anyone. Her breast milk was delivered (once she was well enough to take it at all) via a hard plastic tube, and she was surrounded by voices that were mostly alien, punctuated by the strange bings and bongs of special-care technology.
Richard Cooke, professor, neonatal medicine, Liverpool Womenâ€™s Hospital, England, and an adviser to the premature baby charity Bliss, agrees that there is almost bound to be a knock-on effect. He stresses that studies look at populations and not at individual children, but much of the data he quotes makes sobering listening for a mother like me. When they are older, premature babies of the sort of gestation and weight Rosie was, apparently, tend on average to have a lower IQ, take fewer school examinations and do less well in those that they do take, socialise less effectively with their peer group and find it harder to concentrate. They also tend to be shorter, and have a higher tendency to asthma and eye problems.
Doctors believe that while prematurity can never be the best start in life, it is not the final word. Evidence suggests that the effects of being born too soon can be mitigated by a supportive early environment. Whatâ€™s more, existing studies are inevitably outdated when it comes to an individual childâ€™s future: technology is improving all the time, so a child like Rosie cannot be compared with a group of older premature babies who will have been treated with now-outdated techniques.