The in utero passage of meconium by very low birth weight infants: a marker for adverse outcomes.
OBJECTIVE
To determine the incidence of in utero meconium passage and the rate of associated complications among VLBW infants.


METHODS
Retrospective review of medical records and prospective evaluation of placental samples from 431 VLBW infants who survived >24 h. Cases with histologic evidence of meconium were re-examined and hemosiderin excluded by a negative iron stain. Statistical analysis included chi2, logistic regression, Student's t-test and Kruskal-Wallis.


RESULTS
The 70 infants (16.2%) who had placental evidence of in utero meconium passage were younger, weighed less, and more likely to be delivered by C-section (P = 0.006), intubated in the delivery room (P = 0.02), receive chest compressions (P = 0.003), require volume resuscitation (P = 0.001) and develop grade III-IV intraventricular hemorrhages (P = 0.011) than were control infants.


CONCLUSIONS
Microscopic evaluation of the placental membranes reveals that the in utero passage of meconium occurs in about 16% of premature infants and is associated with adverse perinatal outcomes, including the need for resuscitation at delivery and an increased risk for grade III-IV intraventricular hemorrhages.
Henry
J A
JA
University of Pittsburgh School of Medicine and Magee-Womens Research Institute, Pittsburgh, PA, USA. jhenry@wpahs.org
Baker
R W
RW
Yanowitz
T D
TD
D000653:Amniotic Fluid / Q000737:chemistry; D015415:Biomarkers / Q000032:analysis; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D008297:Male; D008470:Meconium / Q000378:metabolism*; D018743:Perinatal Care; D010920:Placenta / Q000378:metabolism* / Q000473:pathology; D021041:Placental Circulation; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D046509:Tissue Culture Techniques
D015415:Biomarkers