SINGAPORE - A baby weighing just 345g, which is about the weight of a can of soft drink, who was born seven months ago and is possibly the lightest infant to have survived premature birth in Singapore, is now a "hefty" 4.27kg.
A typical pregnancy lasts about 40 weeks, with a full-term pregnancy considered to be at least 37 weeks.
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.
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 pandemic 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 on whether the baby should be delivered by emergency C-section.
Madam Rohani had initially gone to hospital to seek help for abdominal pain, and expected to go 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 complication during pregnancy 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 intensive care unit right after delivery.
"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 very rare for babies to be born before 24 weeks of gestation. There were a few at NUH in the past few years and three survived.
Before Nur Zaiya, the lightest baby delivered at NUH weighed 460g, and that was in 2016, he said.
Almost one in 10 babies are born between 24 and 37 weeks. One out of 100 babies born are 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 are 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 has been given medication for a 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, Nur Zaiya has done very well, said her parents. When she was discharged after 131 days, she weighed about 2kg. She was breathing normally, did not need additional respiratory support, and was on full bottle feeding. NUH's nurse clinician Wang Xia, who took care of her, described her recovery as a feat, as many premature babies are discharged with oxygen support.
Going forward, she will be undergoing regular check-ups to make sure all is well. At six months, she is on a par with an infant of about two months old, which is to be expected, as she was born four months premature.
Checks on a website that tracks the world's tiniest surviving babies, or those that weigh below 400g at birth, showed that of the 269 babies on the list, the ones born in Asia are mostly from Japan.
The world's smallest surviving baby is believed to be a girl nicknamed "Saybie", who was born in December 2018 in San Diego, in the United States. She was born at 23 weeks and three days and weighed just 245g. Her weight was similar to a large apple, and she was discharged from hospital at 2.2kg after five months.