Gulcan Hande, Gungor Serdal, Tiker Filiz, Kilicdag Hasan
Baskent University, Adana Teaching and Research Center, Department of Pediatrics,Adana, Turkey.
Inonu University, Turgut Ozal Medical Center, Faculty of Medicine, Department of Pediatrics, Malatya, Turkey.
Curr Ther Res Clin Exp. 2006 May;67(3):214-25. doi: 10.1016/j.curtheres.2006.06.002.
Delayed passage of first stool by a newborn after birth might be an initial sign of clinical problems, such as meconium ileus, meconium plug syndrome, and intestinal atresia. Successful treatment of these conditions depends on early diagnosis, so it is imperative to note the time of first stool passage.
The aim of this study was to assess the timing of first stool passage by preterm newborns in relation to antenatal exposure to magnesium sulfate (MgSO4) and a glucocorticoid (betamethasone) and to other perinatal factors, such as gestational age, respiratory distress syndrome (RDS), and time of first enteral feeding.
The subjects in this prospective, open study were preterm newbornswho were born before 37 weeks' gestation and admitted to the neonatal intensive care units of Baskent University, Adana Teaching and Research Center, and Inonu University, Turgut Ozal Medical Center, between June 2003 and August 2004. Effects of antenatal exposure to MgSO4 and glucocorticoid on the timing of first stool passage were assessed by comparing findings in exposed newborns to findings in an equal-sized group of gestational-age-matched subjects, derived from the study cohort, who were not exposed. Relationships between time of first stool passage and both gestational age and time of first enteral feeding were assessed.
Two hundred premature newborns (112 males, 88 females) were included in the study. The median age at the time of first stool passage was 16 hours, and 187 (93.5%) passed their first stool by 72 hours after birth. Delayed passage of first stool was noted in 33 (16.5%) newborns. One hundred sixty-eight (84.0%) newborns passed stool before enteral feeding was started. Gestational age and time to first enteral feeding were both significantly correlated with time of first stool passage (gestational age: r = -0.259, P < 0.001; first enteral feeding: r = 0.168, P = 0.017). Time of first stool passage was significantly later in 46 newborns with RDS than in 46 gestation al-age-matched newborns without RDS (mean [SD], 44.7 [39.7] vs 20.5 [18.4] hours, respectively; P < 0.05). The newborns whose mothers had received MgSO4 for tocolysis passed their first stool significantly later than gestational-age-matched controls (mean [SD], 26.5 [26.9] vs 11.3 [12.1] hours, respectively; P < 0.05). Antenatal exposure to betamethasone was not significantly correlated with timing of first stool passage.
The results suggest that delayed passage of first stool in thesepreterm newborns was associated with gestational immaturity, delayed first enteral feeding, and RDS. Antenatal maternal exposure to MgSO4 was associated with later first stool passage in these preterm newborns, whereas antenatal exposure to betamethasone was not.
新生儿出生后首次排便延迟可能是临床问题的初始迹象，如胎粪性肠梗阻、胎粪堵塞综合征和肠道闭锁。这些病症的成功治疗取决于早期诊断，因此记录首次排便时间至关重要。
本研究旨在评估早产新生儿首次排便时间与产前硫酸镁（MgSO4）和糖皮质激素（倍他米松）暴露以及其他围产期因素（如胎龄、呼吸窘迫综合征（RDS）和首次肠内喂养时间）之间的关系。
这项前瞻性、开放性研究的对象是妊娠37周前出生并于2003年6月至2004年8月期间入住巴斯肯特大学、阿达纳教学与研究中心以及伊诺努大学图尔古特·奥扎尔医学中心新生儿重症监护病房的早产新生儿。通过将暴露新生儿的结果与从研究队列中选取的同等数量、胎龄匹配且未暴露的对照组新生儿的结果进行比较，评估产前硫酸镁和糖皮质激素暴露对首次排便时间的影响。评估首次排便时间与胎龄和首次肠内喂养时间之间的关系。
200名早产新生儿（112名男性，88名女性）纳入研究。首次排便的中位年龄为16小时，187名（93.5%）新生儿在出生后72小时内排出首次粪便。33名（16.5%）新生儿首次排便延迟。168名（84.0%）新生儿在开始肠内喂养前排出粪便。胎龄和首次肠内喂养时间均与首次排便时间显著相关（胎龄：r = -0.259，P < 0.001；首次肠内喂养：r = 0.168，P = 0.017）。46名患有RDS的新生儿首次排便时间显著晚于46名胎龄匹配但无RDS的新生儿（分别为平均[标准差]44.7 [39.7]小时和20.5 [18.4]小时；P < 0.
