Weighing just 345g at birth, tiny baby on road to recovery now

7 months on, one of the lightest babies to survive premature birth here is 4.27kg

Nur Zaiya Naziha Muhammad Saufi was born after 23 weeks and six days to Madam Rohani Mustani and Mr Muhammad Saufi Yusoff. PHOTOS: NG SOR LUAN, COURTESY OF ROHANI MUSTANI AND MUHAMMAD SAUFI YUSOFF

A baby weighing just 345g, nearly the same as a can of soft drink, who was born seven months ago and is among the lightest infants to have survived premature birth in Singapore, is now a "hefty" 4.27kg.

Born after just 23 weeks and six days, Nur Zaiya Naziha Muhammad Saufi could fit in the palm of a hand and her limbs were the size of an adult finger. A typical pregnancy lasts about 40 weeks, with a full-term pregnancy considered to be at least 37 weeks.

In 2015, a baby weighing 315g was born and survived after more than six months in the neonatal intensive care unit (NICU) at the Singapore General Hospital (SGH).

Nur Zaiya is the smallest baby to be discharged from the National University Hospital (NUH). She was born on March 27 at the height of the Covid-19 outbreak as Singapore was about to go into a two-month circuit breaker.

Her parents, Madam Rohani Mustani, 37, a logistics officer, and Mr Muhammad Saufi Yusoff, 36, a system technician, took about two to three hours to decide whether the baby should be delivered.

Madam Rohani had initially gone to hospital to seek help for abdominal pain, and expected to return home to rest. "I thought it was just normal gastric pain... But A&E told me I had symptoms of pre-eclampsia, which was quite shocking, and I had to deliver the baby the next day," she said. Pre-eclampsia is a pregnancy complication characterised by high blood pressure.

Madam Rohani was informed that her baby had a 20 per cent chance of survival, but the parents decided to take a leap of faith. The infant was wheeled to the NICU right after delivery by emergency caesarean section.

"It was either me or her, during that time. The doctor said my blood pressure was very elevated... I had to deliver her as soon as possible. Otherwise, it could jeopardise my life," the mother said.

"Twenty per cent is still hope. Whatever happens, it's up to fate. I am just glad I delivered."

Nur Zaiya is the couple's fourth child. They have two other daughters, aged seven and four, and a son, aged six.

Dr Krishnamoorthy Niduvaje, a senior consultant at the department of neonatology at NUH, said it is rare for babies to be born before 24 weeks of gestation. Almost one in 10 babies in Singapore is born between 24 and 37 weeks. One out of 100 babies born is below 1,500g and will need to be in intensive care. These babies are usually born before 32 weeks, said Dr Niduvaje.

One in five babies is born prematurely because of pre-eclampsia, he added. The more premature the babies are, the more health complications they are likely to have.

Nur Zaiya Naziha Muhammad Saufi will be undergoing regular check-ups to make sure all is well. ST PHOTO: NG SOR LUAN

Nur Zaiya has been given medication for the small hole in her heart, and has undergone laser treatment for retinopathy of prematurity, or ROP, an eye disease seen in babies born before 31 weeks.

So far, she has done very well, said her parents. When she was discharged after 131 days in NICU, she weighed about 2kg, was breathing normally and on full bottle feeding.

NUH nurse clinician Wang Xia, who took care of her, described her recovery as a feat because many premature babies are discharged with oxygen support.

At seven months, she is on a par with an infant of about two months, which is to be expected as she was born four months premature.

The lightest surviving baby at KK Women's and Children's Hospital (KKH), which is Singapore's largest tertiary perinatal centre, was born in 2014. Delivered at 25 weeks and two days, she weighed 400g but was discharged at 5.66kg after 178 days in NICU.

Seven-month-old Nur Zaiya - seen here with her parents Rohani Mustani, 37, and Muhammad Saufi Yusoff, 36 - was born on March 27 and is the smallest baby to be discharged from the National University Hospital. The couple have two other daughters, aged
Seven-month-old Nur Zaiya - seen here with her parents Rohani Mustani, 37, and Muhammad Saufi Yusoff, 36 - was born on March 27 and is the smallest baby to be discharged from the National University Hospital. ST PHOTO: NG SOR LUAN

"At six years old now, the child is smaller in size compared with her peers, but does not have any major medical concerns and she will be going to mainstream school next year," said Dr Khoo Poh Choo, deputy head and senior consultant at KKH's neonatology department.

Dr Vijay Baral, a senior consultant at SGH's neonatal and developmental medicine department, said more than 85 babies were delivered at 26 weeks or less at the hospital in the past five years.

Caring for extremely premature babies is challenging but with advances in medical knowledge and technology, over the past few decades, outcomes continue to get better, he said. "Survival rates for premature babies born in Singapore are comparable to any developed nation today," he added.

The world's smallest surviving premature baby is believed to be a girl nicknamed "Saybie", who was born in December 2018 in San Diego, in the United States, at 23 weeks and three days and weighing just 245g.

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A version of this article appeared in the print edition of The Straits Times on October 27, 2020, with the headline Weighing just 345g at birth, tiny baby on road to recovery now. Subscribe