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Story highlights

A preterm baby born at 21 weeks, four days is now a healthy 3-year-old girl, doctors say

Doctor: 'Be very cautious about generalizing one good outcome to a larger population'

(CNN) —  

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 gestation. “She may be the most premature known survivor to date,” according to a case report about her birth published in the journal Pediatrics last week.

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.

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-affiliated 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 four 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.

At three weeks old in 2014, Courtney Stensrud's daughter is pictured here with Stensrud's and her husband's wedding rings on her arm.
Courtesy Courtney Stensrud
At three weeks old in 2014, Courtney Stensrud's daughter is pictured here with Stensrud's and her husband's wedding rings on her arm.

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.”

’She very slowly changed colors from blue to pink’

Around the world, an estimated 15 million babies are born too early – before 37 weeks gestation – every year, according to the World Health Organization.

Last year, preterm birth affected about one of every 10 infants born in the United States, according to the Centers for Disease Control and Prevention.

There has been an increase in the prevalence of preterm births in the United States, with an additional 8,000 babies being born prematurely last year due to a rise in the preterm birth rate between 2015 and 2016, according to a report released Wednesday from the nonprofit organization March of Dimes.

Pediatric and obstetric professional society guidelines are routinely updated to answer that challenging question of when resuscitating a preterm baby should be recommended or not.