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Oral diatrizoate acid for meconium-related ileus in extremely preterm infants

Kaori Michikata1, Yuki Kodama1, Masatoki Kaneko1

  • 1Department of Obstetrics and Gynecology, University of Miyazaki, Kiyotake, Miyazaki, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|May 28, 2018
PubMed

Insights

Prophylactic oral diatrizoate acid effectively prevented meconium-related ileus (MRI) in extremely preterm infants. This intervention also reduced mortality rates in very premature infants, showing significant benefits.

Area of Science:

  • Neonatal Medicine
  • Gastroenterology
  • Pediatric Surgery

Background:

  • Intestinal disorders are a significant concern in extremely preterm infants.
  • Meconium-related ileus (MRI) is a serious complication in this vulnerable population.

Purpose of the Study:

  • To investigate the efficacy of prophylactic oral Gastrografin (diatrizoate acid) in preventing MRI.
  • To assess the impact of this intervention on clinical outcomes in extremely preterm infants.

Main Methods:

  • A retrospective case-control study compared extremely preterm infants (<28 weeks gestation) who received prophylactic diatrizoate acid with a matched control group.
  • Infants with congenital abnormalities or early mortality were excluded.
  • Outcomes analyzed included MRI incidence, time to full enteral feeding, hospital stay duration, and mortality rates.

Main Results:

  • No cases of MRI were observed in the prophylactic diatrizoate acid group, compared to six cases in the control group (P = 0.039).
  • The prophylactic group experienced a shorter median time to full enteral feeding (22 vs. 25 days) and a shorter hospital stay (126 vs. 142 days).
  • Mortality rate for infants aged 24-27 weeks was significantly lower in the prophylactic group (0% vs. 8.2%, P = 0.021).

Conclusions:

  • Prophylactic oral diatrizoate acid is effective in reducing MRI in extremely preterm infants.
  • The intervention demonstrates a significant reduction in mortality for infants born at 24-27 weeks gestation.
  • Oral diatrizoate acid appears to be a beneficial prophylactic measure for extremely preterm infants without observed side-effects.
Abstract

Keywords:
extremely preterm infantfocal intestinal perforationgastrografinmeconium-related ileusnecrotizing enterocolitis

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