Kumar S L, Dhanireddy R
Department of Pediatrics, Georgetown University Medical Center, Washington, D.C. 20007-2197, USA.
J Pediatr. 1995 Dec;127(6):971-4. doi: 10.1016/s0022-3476(95)70041-2.
To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate and glucocorticosteroids, on the timing of the first stool in preterm infants.
Medical records of all preterm infants (born at < or = 36 weeks of gestational age) admitted to the neonatal intensive care unit at Georgetown University Hospital between April 1993 and March 1994 were reviewed. We studied the time of the first stool in 221 infants after removing from the investigation the 45 infants who met the exclusion criteria.
The median age of the infants at the time of the first stool was 18 hours, and 90% of the infants passed stool by 100 hours after birth. Both the gestational age and the illness severity, as measured by the Score for Neonatal Acute Physiology (SNAP), independently correlated with the timing of first stool (r = 0.31 and p < 0.0001 for gestational age; r = 0.33 and p < 0.0001 for SNAP). Of the 221 infants, 172 (78%) passed stool before the initiation of enteral feeding. Antenatal exposure to magnesium sulfate for tocolysis had no effect on the timing of the first stool, whereas infants whose mothers received glucocorticosteroids for enhancing fetal lung maturity passed their first stool significantly earlier than nonexposed infants of identical gestational age (p = 0.005).
Delayed passage of first stool is a function of both illness severity and gestational immaturity. Antenatal betamethasone exposure leads to earlier stool passage, whereas antenatal exposure to magnesium sulfate does not affect the timing of first stool in premature infants.
评估胎龄和疾病严重程度，以及产前硫酸镁和糖皮质激素暴露对早产儿首次排便时间的影响。
回顾了1993年4月至1994年3月间入住乔治敦大学医院新生儿重症监护病房的所有早产儿（胎龄≤36周）的病历。我们研究了221例婴儿的首次排便时间，其中45例符合排除标准的婴儿被排除在研究之外。
婴儿首次排便时的中位年龄为18小时，90%的婴儿在出生后100小时内排便。胎龄和疾病严重程度（通过新生儿急性生理学评分（SNAP）衡量）均与首次排便时间独立相关（胎龄r = 0.31，p < 0.0001；SNAP r = 0.33，p < 0.0001）。在221例婴儿中，172例（78%）在开始肠内喂养前排便。产前使用硫酸镁进行保胎治疗对首次排便时间没有影响，而母亲接受糖皮质激素以促进胎儿肺成熟的婴儿比相同胎龄未暴露的婴儿首次排便明显更早（p = 0.005）。
首次排便延迟是疾病严重程度和胎龄不成熟共同作用的结果。产前倍他米松暴露导致排便提前，而产前硫酸镁暴露不影响早产儿首次排便时间。
