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
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
Conclusion: Despite similar morbidity SGA infants exhibited higher lethal complication rates following
delayed meconium passage compared to AGA infants.
Preterm Infants; Meconium; Necrotizing Enterocolitis; Neonate; Infant, Small for Gestational Age