title: Delayed meconium passage in small vs. appropriate for gestational age preterm infants: management and short-term outcome.
abstract: 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.
  
  
  RESULTS
  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 (P=0.03).
  
  
  CONCLUSIONS
  Despite similar morbidity SGA infants exhibited higher lethal complication rates following delayed meconium passage compared to AGA infants.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Medical University of Graz, Austria. wolfgang.raith@klinikum-graz.at
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Raith
authors.forename: Bernhard
authors.initials: B
authors.lastname: Resch
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pichler
authors.forename: Heinz
authors.initials: H
authors.lastname: Zotter
authors.forename: Berndt
authors.initials: B
authors.lastname: Urlesberger
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Mueller
keywords: Infant; Meconium; Necrotizing Enterocolitis; Neonate; Preterm Infants; Small for Gestational Age
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