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 7 th 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 7 th 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. Conclusions. 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.