Clinical Characteristics and Outcome of Very Low Birth Weight Infants with Surgical Meconium Related Ileus

Abstract

Objective: Meconium related ileus (MRI) was defined as functional ileus in neonates characterized by impaired meconium excretion with preferential occurrence in very low birth weight (VLBW) infants. The aim of this study was to investigate the clinical characteristics and outcome of VLBW infants who underwent surgical treatement, especially exploratory laparotomy and ileostomy, due to MRI. Methods: This retrospective study included VLBW infants born in our hospital between January 2010 and December 2018. Infants were included if they were diagnosed with MRI and underwent exploratory laparotomy. In order to compare the clinical characteristics, matched controls for each subject were chosen. Results: Among the 178 VLBW infants delivered during the study period, total 19 cases and 19 controls were identified. The mean GA and birth weight in the MRI group were 27.6±1.9 weeks and 966±233 g, respectively, and 28.7±2.2 weeks and 1,005±198 g, respectively, in the control group. There was no significant difference between the both groups in perinatal, maternal and neonatal characteristics such as respiratory distress syndrome (RDS). Day of full enteral feeding and hospitalization were significantly longer in MRI group compared to control group). The proportion of less than 3 percentile for postmenstrual age at discharge were significantly higher in MRI group (73% vs. 21%, P=0.001). Conclusion: The results of our study showed that delayed treatment of MRI lead to longer hospital stay and lower weight at discharge. Early treatment including exploratory laparotomy should be considered to improve outcome when the baby was suspected MRI with risk factors.