New Zealand preterm twins born at 23 weeks



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When Declan Colquhoun was born, his aunt’s wedding ring would have been wrapped around his arm.

He and his twin brother Riley were born at just 23 weeks and one day on March 3. The limit of viability is considered: babies born earlier are not usually resuscitated.

Declan weighed just 400g, a photo of him next to a pen shows how small he is, while Riley weighed 530g.

Just over two weeks later, Riley lost her fight for life, while eight months later, Declan moved out of Wellington Hospital’s neonatal intensive care unit this week and grows stronger every day. Now it weighs 7 kg.

At 22 weeks pregnant, the twins’ mother, 23-year-old Kathryn Hutchinson, discovered she had high blood pressure while on a midwife appointment. She was diagnosed with pre-eclampsia, a condition that affects pregnant women, and doctors decided it was safer for her to have babies.

They were delivered by caesarean section. Their eyes were still closed from fusion, they were put directly into fans, and Hutchinson and his partner Chris Colquhoun were unable to hold their baby boys.

Colquhoun soon had to return to his job in traffic management.

“The reality is that life goes on. The bills don’t stop.”

On March 17, the Upper Hutt couple received a call that Declan was fighting for his life. They ran to the hospital for hugs, their first since he was born, preparing for the worst. But he struggled and it was Riley whose kidneys began to fail the next day.

“In the early hours of March 19, her little body decided enough was enough and her wings grew,” Hutchinson said.

The couple had a small funeral for their 16-day-old son, days before the country was blocked.

Then, at three weeks old, Declan opened his eyes for the first time.

But things got more difficult. Only mothers were allowed to visit their babies in the unit due to the risk of Covid-19, so Colquhoun would take Hutchinson to the hospital and wait outside in the parking lot. He didn’t see Declan for six weeks.

“It was horrible,” Hutchinson said. “He had just lost his son and his other son was fighting for his life and he couldn’t be there.”

Declan’s recovery has been a slow process. He had three surgical procedures in one week.

“It was extremely fragile.”

Hutchinson spent the whole day by his bedside and returned at night with Colquhoun after finishing work.

But about a month ago Declan was well enough to go outside for the first time in his life. His parents took him for a walk around the hospital grounds.

And this week, he was transferred from intensive care to a special baby care unit at Hutt Hospital, but he still needs oxygen and a tube to feed himself.

“It is a step in the right direction,” says Hutchinson.

“Good things take time. His development is delayed, but now he smiles and makes little noises.”

The couple also have a wedding to look forward to when Declan is well enough: Colquhoun proposed in September.

Declan is defying the odds.

The latest data from the Ministry of Health shows that between 2013 and 2017 237 babies were born alive with a gestation period of 22 to 23 weeks. Of them, 230 babies died.

The number of babies that were part of a group of twins that survived at such an early stage would also be extremely rare.

The president of the Pediatric Society, Nicola Austin, said that last year a task force reached a consensus to resuscitate babies born after 23 weeks of gestation, with preparation starting at 22 weeks and five days. The threshold in some hospitals had been 24 weeks.

The use of corticosteroids in mothers in preterm labor (which was developed in New Zealand and is used globally) and less aggressive pulmonary ventilation are among recent medical advances that mean babies born this early can be saved.

But Austin knows of a baby who survived to 22 weeks and six days and a baby weighing less than 400 g who survived to 24 weeks.

Hutchinson has been supported by the Neonatal Trust, which offers things like care packages, grocery vouchers and gas, and hosts family gatherings with speakers.

Executive Director Rachel Friend said saving smaller babies placed a greater demand on trust, as did Covid-19.

He lost more than $ 100,000 due to canceled fundraising events. But in September, Hell Pizza donated $ 2 from every Unholy Donut sold to the trust – 34,248 were eaten, raising $ 68,496.

Friend’s 7-year-old son, Reuben, was born at 24 weeks, which at the time was “highly regarded as the line of viability.”

It weighed 665 g and could have fallen into the palm of his hand if he had been allowed to hold it, but his skin “was like paper.”

But now it is thriving.

“You wouldn’t know something is wrong. He’s reading above his age level, he plays soccer, nothing, he wants to play basketball next year, he loves mountain biking.”

Premature babies in New Zealand

• The youngest baby known to survive preterm birth was born at 22 weeks and six days gestation.

• Hospitals resuscitate after 23 weeks.

• Between 2013 and 2017 there were 237 live-born babies with a gestation period of 22 to 23 weeks. There were 230 infant deaths at the same time with the same gestation period.

• About 10 percent of all babies are born premature (before 37 weeks’ gestation). That’s one every 90 minutes.

• There are six Neonatal Intensive Care Units (NICU) in New Zealand that carry babies born before 32 weeks and 17 Special Care Infant Units (SCBU) in regional hospitals. Five thousand families a year use the facilities.

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