The Time of First Passage of Meconium in Inborn Neonates in Baghdad Teaching Hospital- Medical City

The first passage of stool after birth (meconium), is delayed in preterm neonates compared to term neonates. Ninety-nine percent of term infants and 76% of premature infants pass a stool in the first 24 hours of life. Ninety-nine percent of premature infants pass a stool by 48 hours. To explain the effect of some factors on the time of first passage of meconium(POM) in neonates. Between January and March 2009, all neonates born in Baghdad teaching Hospital-medical city-Baghdad, with gestational age (GA) of 28-42 weeks and without metabolic, congenital or gastrointestinal diseases, were included. Neonates were divided into four groups: A. GA ≤ 30 weeks, B GA 31-34 weeks, C GA 35-36 weeks, D GA ≥ 37 weeks(term). Neonates were followed for first POM. A total of 222 neonates (115 males); 12, 22, 29 and 159 neonates in group A, B, C and D respectively were included. With decreasing gestation, a trend was found for delayed first POM (P<0.0001).Compared to term neonates 157/159 (98.7%), less preterm neonates passed their first stool within 24 hours after birth group A; 2/12 (16.6%); group B; 9/22 (40.9%); and group C; 26/29 (89.6%). First POM was associated with birth weight < 2.5 kg (P= 0.0001), 42/69 (60.8%) of neonates passed their first stool within 24 hours after birth, compared to 152/153 (99.3%) of neonates > 2.5 kg. The time of first POM was associated with type of feeding (P=0.0001) and with the need for respiratory support, (P=0.0001). First POM was not associated with gender, and birth weight in relation to GA. More than (98.7%) of term neonates passed their first stool within 24 hours after birth. The first POM was delayed in preterm neonates compared to term neonates. The first POM was significantly associated with gestational age. It was also delayed with decreasing birth weight, and in neonates who need respiratory support compared to those who did not. The first POM was earlier in breast fed neonates compared to formula fed or combined type of feeding.