Ezomike Uchechukwu Obiora, Ugwu Emmanuel Onyebuchi, Ezomike Nkeiruka Elsie, Eke Christopher Bismarck, Ekenze Sebastian Okwuchukwu
Sub-Department of Pediatric Surgery Faculty of Medical Sciences, College of Medicine, University of Nigeria Ituku/Ozalla Campus, Enugu state, Nigeria.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria Ituku/Ozalla Campus, Enugu state, Nigeria.
Malawi Med J. 2019 Jun;31(2):150-154. doi: 10.4314/mmj.v31i2.8.
Delayed meconium passage is usually a signal to congenital distal bowel dysfunction. Timing of meconium passage may vary depending on race, sex and several perinatal factors. Understanding the timing and associated perinatal factors in any given population will help in prompt diagnosis and adequate management of cases in that population.
To determine the timing of first meconium passage amongst Nigerian neonates, and evaluate the impact of various associated perinatal factors.
A cross-sectional study using interviewer-administered questionnaires to obtain data from mothers of apparently normal infants attending the postnatal clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Data acquisition and analysis were done using SPSS version 20. A P-value of < 0.05 was adjudged statistically significant.
There were 276 male and 277 female infants. Mean birth weight was 3.4kg and mean gestational age at delivery 38.8weeks. The median age at presentation was 42days. Preterm deliveries were in 6.3%(32/510) and 3.7%(20/536) weighed less than 2.5kg at birth. Sixty-five percent (339/519) had spontaneous vertex delivery and 35%(180/519) had caesarean delivery. Passage of first meconium was within 24hours in 56.6%(307/543) and in 48hours 91.3%(496/543) had passed meconium. Fifty-four percent (54%, 288/537) commenced breastfeeding within 24hours and 85% (n=456/537) within 48hours. Exclusive breastfeeding was done in 61.5%(326/533) of subjects. Timing of first meconium passage was significantly affected by gestational age at delivery (p<0.001), mode of delivery (p<0.01), birth weight (p=0.02), first minute APGAR score (p<0.001), timing of commencement of breastfeeding (p<0.001) and feeding before breastfeeding is commenced (p = 0.02).
Compared to other studies, we found smaller proportion of neonates passing meconium in the first 24 hours. Term neonates, birth weight ≥ 2.5kg, spontaneous vertex delivery, high Apgar score, commencement of breastfeeding within 24 hours of birth, feeding before breastfeeding is commenced, are perinatal factors associated with earlier first meconium passage.
胎粪排出延迟通常是先天性远端肠道功能障碍的一个信号。胎粪排出的时间可能因种族、性别和一些围产期因素而有所不同。了解特定人群中胎粪排出的时间及相关围产期因素，将有助于对该人群中的病例进行及时诊断和妥善管理。
确定尼日利亚新生儿首次排出胎粪的时间，并评估各种相关围产期因素的影响。
采用访谈式问卷进行横断面研究，以获取来自尼日利亚埃努古大学教学医院产后门诊中表面正常婴儿母亲的数据。使用SPSS 20版进行数据采集和分析。P值<0.05被判定具有统计学意义。
有276名男婴和277名女婴。平均出生体重为3.4kg，平均分娩孕周为38.8周。就诊时的中位年龄为42天。早产率为6.3%（32/510），出生时体重低于2.5kg的占3.7%（20/536）。65%（339/519）为自然头位分娩，35%（180/519）为剖宫产。56.6%（307/543）的婴儿在24小时内排出首次胎粪，91.3%（496/543）在48小时内排出胎粪。54%（288/537）的婴儿在24小时内开始母乳喂养，85%（n = 456/537）在48小时内开始。61.5%（326/533）的受试者进行纯母乳喂养。首次排出胎粪的时间受分娩孕周（p<0.001）、分娩方式（p<0.01）、出生体重（p = 0.02）、1分钟阿氏评分（p<0.001）、开始母乳喂养的时间（p<0.001）以及在开始母乳喂养前是否喂养（p = 0.02）的显著影响。
与其他研究相比，我们发现24小时内排出胎粪的新生儿比例较小。足月儿、出生体重≥2.5kg、自然头位分娩、阿氏评分高、出生后24小时内开始母乳喂养、在开始母乳喂养前进行喂养，是与较早排出首次胎粪相关的围产期因素。
