Premature babies

Early birth complications
'Every day of development during pregnancy is precious to the health of an unborn baby,' said Dr Jennifer Howse, president of the March of Dimes, a voluntary organisation that funded a study of several million American and Canadian babies born prematurely. 'The finding that prematurity is associated with higher risk of death gives even greater urgency to our efforts to find ways to prevent pre-term birth from occurring.'

Advances in neonatal intensive care technology mean that a 33-week baby stands a very good chance of survival. But Jennifer's low birth weight added to her fragility. Her vital systems were not sufficiently developed, as she was the size and weight of a baby at 28 weeks gestation.

Risks to the brain
Although babies born as young as 23 weeks have survived, there is a higher risk of infection, lung damage, cerebral haemorrhage and water on the brain, and later developmental delays and handicap.

The large numbers of tiny capillaries required to supply the brain with blood can be very fragile in a premature infant. Cerebral haemorrhage is a risk, and premature babies are scanned by ultrasound within days of birth to check for bleeding, as it can be difficult to diagnose.

If the amount of blood leaking is small, then the brain eventually reabsorbs it and the baby recovers. No treatment, apart from sedation to keep the baby calm, is currently available. However, there is evidence that Jennifer suffered a serious cerebral haemorrhage within days of birth and, in spite of the very best medical care, was too fragile to survive in the outside world. After just ten days of life, she died quietly in her parents' arms.

Most of us are allowed to mourn in private - Gordon and Sarah Brown had the added burden of having to bear their grief in the public eye.

Research is continuing into the risks of low birth weight and prematurity. There is some evidence that magnesium taken during pregnancy can help prevent cerebral haemorrhage.