Courtney Stensrud and her husband call their fun-loving, spunky daughter a miracle.
The now 3-year-old girl was born at just 21 weeks and four days after conception. "She may be the most premature known survivor to date," according to a case report about her birth published in the journal Pediatrics on Thursday.
In the United States, most pediatrics and obstetrics societies agree that 22 weeks of gestation is the lower threshold of viability, and many doctors recommend against assessing for viability or resuscitating babies born younger than 22 weeks due to a low chance of survival. Full-term babies are born at 39 through 40 weeks.
As CNN reports, before a medical emergency led to the early birth of her daughter in 2014, while still in the antepartum room at Methodist Children's Hospital in San Antonio, Texas, Stensrud said that she searched online for any other mothers who gave birth at 21 weeks.
"There were stories of 22-weekers, 23-weekers, but nothing about 21-weekers. So I knew that there was little to no survival or viability at 21 weeks," said the stay-at-home mom, now 35.
Just after Stensrud gave birth, Dr. Kaashif Ahmad, a MEDNAX-affiliate neonatologist at the hospital and lead author of the case report, counseled her about the baby's extremely low chances of survival and initially counseled against resuscitating the baby.
Stensrud listened as she held her 15-ounce girl in her arms, with the umbilical cord still attached, she said.
"Although I was listening to him, I just felt something inside of me say, 'Just have hope and have faith.' It didn't matter to me that she was 21 weeks and 4 days. I didn't care," Stensrud said.
"As he was talking to me, I just said, 'Will you try?' And he said he would, and three years later, we have our little miracle baby," Stensrud said.
"I don't tell her story a lot, but when I do, people are amazed," she said. "If there's another woman in antepartum that is searching Google, they can find this story and they can find a little bit of hope and a little bit of faith."
Stensrud requested that CNN not publish her daughter's name or current photos to respect her family's privacy.
Ahmad pointed out that Stensrud's daughter was one case, and more research needs to be done on preterm births lower than 22 weeks.
"We have to be very cautious about generalizing one good outcome to a larger population," Ahmad said.
"It is very possible that there have been many 21-week babies resuscitated in other places that did not have positive outcomes, and for that reason, we haven't heard about them," he said. "We reported this case because after this resuscitation she did well, but it may be possible that this is just an extraordinary case and that we shouldn't expect the same from other babies. We have to learn more before we can make any conclusions."
In the new case report, Ahmad and his colleagues describe how they resuscitated Stensrud's daughter and how she needed prolonged care in the neonatal intensive care unit, known as the NICU. She wasn't discharged from the hospital until 126 days after being born.
By 2 years old, even though she was smaller in size than her peers, Stensrud's daughter achieved scores that were average for a child around 20 months on Bayley III tests, according to the report. The tests, intended to measure child development up to age 3, assessed her cognitive, motor and language abilities.
"For this little girl, we say that her fine motor was age equivalent of 20 months," Ahmad said.
"That is what we would expect the average 20-month baby to do," he said. "She was at that time 24 months, but as we noted in the case, if you take into account how many weeks early she was, she was actually about 20 months, corrected."
She did not develop any auditory or visual impairments or cerebral palsy, according to the report, and she now attends preschool.