Abstract
Passage of meconium (M) after 24hrs of age in term neonates is considered to be delayed and may require diagnostic and/or therapeutic intervention. However, little is known about the time of passage of first meconium and the clinical implications in premature (P) infants weighing ≤1500gms. Sixty consecutive P born between July 1985-March 1986 were studied; six of the sixty died before passing M. The mean±S.D. birth wt. was 1144±224gms, gestational age 30.6±2.24wks, Apgar score at one minute 4±2 and at five minutes 7 ± 2. Feedings were started at 4.4±2.5 days. Time of passage of meconium is shown:
There was a significant correlation between time of passage of meconium and birth wt. (r = −0.489, p<0.001) and gest. age (r = −0.334, p<0.01); no significant correlation was noted with Apgar score, feeding, peak bilirubin levels, phototherapy or electrolytes. Time of passage was significantly longer in P with HMD vs Transient Tachypnea of Newborn (TTNB) (33±30 vs 16±17hrs, p<0.05). Only one P had abdominal distension and passed M plug at 47hrs of age; others had no signs of bowel obstruction. In summary, only 2/3 of P pass M by 24hrs of age and the remaining 1/3, even though delayed, do not require diagnostic workup unless associated with other signs of bowel obstruction.
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Srinivasan, G., Oak, A., Patel, M. et al. PASSAGE OF FIRST STOOL IN VERY LOW BIRTH WEIGHT INFANTS. Pediatr Res 21 (Suppl 4), 287 (1987). https://doi.org/10.1203/00006450-198704010-00722
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DOI: https://doi.org/10.1203/00006450-198704010-00722