From Preemies to Adults

05/18/2009

When Katie Kenefick '11 was born 15 weeks early, she weighed just 1 pound 14 ounces and was no longer than a dollar bill. Doctors said she had a 50-50 chance of surviving the first 24 hours. Even if she lived, doctors told Katie’s parents she faced the possibility of numerous complications — blindness, stunted growth, learning disabilities. She spent 21 days on a ventilator. In a hospital photo, her father’s wedding ring hangs loosely around her tiny wrist. Twenty years later, Kenefick — now 5 feet 8 inches tall — is a student at the College of St. Benedict with no long-term health problems. She’s been active in cheerleading, band and choir and has taken mission trips to Mexico and Guatemala.

Kenefick is one of three St. Cloud-area college students who were part of a study by Children’s Hospital of Minnesota in Minneapolis. Dr. Ronald Hoekstra, director of neonatology at the hospital, tracked 156 surviving “micro preemies” born there between 1986 and 1990. Most reports on the progress of premature infants involve assessments done when the baby is between 18 and 24 months old. But there was little research on what happened to premature babies in the long term until Hoekstra decided to find out. The grown-up preemies Hoekstra studied were all born at Children’s Hospital at between 23-29 weeks gestation. An average pregnancy is 40 weeks. All of them weighed less than 1,000 grams, or about 2.2 pounds, at birth. Back then, the survival rate for a micro preemie was just 53 percent. Since then, it’s increased to nearly 90 percent, thanks to medical advancements such as improved ventilators and drugs to treat underdeveloped lungs. Caring for the most premature babies is extremely costly, financially as well as psychologically, Hoekstra said. “I think that if we are going to spend these resources, we are obligated to see what the results of our efforts are,” he said. Researchers were able to get long-term data on 116 of the preemies ages 18-22 years, and the results were impressive. Almost 90 percent have graduated from high school and almost 60 percent have gone on to college. Three-fourths have a driver’s license, and nearly 90 percent have been employed. The group includes students with 4.0 GPAs, athletes and musicians. “These are children that are doing extremely well, not only physically, but emotionally,” Hoekstra said.

So was it just luck or something else that helped these preemies thrive? Hoekstra noted that since the early 1980s, Children’s Hospital has been aggressively caring for premature babies, even those born so early that other hospitals wouldn’t have resuscitated them. Sometimes just believing that an extremely premature infant has a good chance of surviving and thriving can make a difference in their prognosis, he said. Half of the preemies in the study were given surfactant, a synthetic substance that was experimental at the time but is now regularly given to premature babies to help their underdeveloped lungs function. Those given surfactant had a higher survival rate, Hoekstra said. There’s another common trait that all the thriving preemies share that’s more difficult to quantitate. “The bottom line was they had parents who went to the wall for them,” Hoekstra said. “They had parents who wouldn’t believe that they weren’t going to be doing well. I would say that’s really a tribute to the
parents.”