Induction of meconium evacuation and stooling habit development in premature infants: role of gestational age

AIM: Meconium obstruction has been viewed as a cause of bowel dysfunction and poorer outcome in preterm neonates. This study investigated whether the need of meconium induction over the 7th postnatal day would relate with later bowel habit development. The study was carried out at the Department of Pediatrics, University of Padua, Italy. METHODS: This was a prospective study, performed on 80 premature infants, separately analyzed in three subgroups according to the gestational ages (Subgroup A [16]: 23-26/6; Subgroup B [26]: 27/0-30/6; and Subgroup C [38]: 31/0-34/6 weeks), after the induction from 7th day of life of meconium evacuation by saline enema. To evaluate stooling habit development, data on constipation occurrence were obtained via a telephone interview with parents six months after neonatal care. RESULTS: At the 23-26/6 weeks subgroup A there was a significant increased risk (RR; 95%, CI) of saline enema to induce meconium passage as compared to subgroups B (2.27; 1.11-4.47) and subgroup C (2.28; 1.04-4.94), with a significant P per trend decrease (P<0.05) with increasing gestational age. Even, at six months of life, subgroup A showed a significant increased risk of constipation as compared to subgroups B (3.25; 1.04-9.75) and C (3.73; 1.19-11.63), respectively. CONCLUSION: The results of this study indicate that meconium retention over the first week of life is a relatively common features in premature subgroup infants of 23-26/6 weeks of gestation. These premature infants at 6 months of age show a stooling habit characterized by frequent constipation