Delayed Meconium Passage in Small vs. Appropriate for Gestational Age Preterm Infants: Management and Short-Term Outcome

Raith Wolfgang; Resch Bernhard; Pichler Gerhard; Zotter Heinz; Urlesberger Berndt; Mueller Wilhelm

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Delayed Meconium Passage in Small vs. Appropriate for Gestational Age Preterm Infants: Management and Short-Term Outcome

Author(s):

Raith Wolfgang ^1,*,

Resch Bernhard ²,

Pichler Gerhard ³,

Zotter Heinz ⁴,

Urlesberger Berndt ⁵,

Mueller Wilhelm ⁶

IJ Pediatrics:Vol. 23, issue 1; 8-12

Published online:Nov 25, 2012

Article type:Research Article

Received:Jul 01, 2012

Accepted:Jul 11, 2012

How to Cite:Raith Wolfgang Resch Bernhard Pichler Gerhard Zotter Heinz Urlesberger Berndt Mueller Wilhelm et al.Delayed Meconium Passage in Small vs. Appropriate for Gestational Age Preterm Infants: Management and Short-Term Outcome.Iran J Pediatr.23(1):8-12.

Abstract

Objective: Delayed passage of stool is a result of both gestational immaturity and illness severity. Small for gestational age (SGA) preterm infants are at high risk of gastrointestinal (GI) complications. We aimed to analyse the effects of a strict nutrition and stool protocol on GI problems in SGA compared to appropriate for gestational age (AGA) preterm infants
Methods: Retrospective cohort analysis including all preterm infants with delayed meconium passage hospitalized at the Neonatal Intensive Care Unit of the Medical University of Graz, Austria. Infants were identified by a local data system and by the use of a strict feeding and stool protocol between 2001 and 2009. Main outcome parameters included neonatal morbidity, surgical intervention and mortality.
Findings: Twenty-six SGA (median GA 28.6 weeks, birth weight 825 grams, 46% males) were compared to 101 AGA (median GA 28.4 weeks, birth weight 1168 grams, 55% males) preterm infants. Clinical signs of delayed meconium passage did not differ significantly between groups. Differences regarding percentage of necrotizing enterocolitis, ileus, spontaneous intestinal perforation, and surgical intervention did not differ between groups. Mortality rate was significantly higher in SGA (11.5%) compared to AGA (2.9%) infants (P=0.03).
Conclusion: Despite similar morbidity SGA infants exhibited higher lethal complication rates following delayed meconium passage compared to AGA infants.

Keywords

Preterm Infants

Meconium

Necrotizing Enterocolitis

Neonate

Infant

Small for Gestational Age

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