Related Experiment Video
Updated: Sep 29, 2025
Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
Glycerin Suppositories and Enemas in Premature Infants: A Meta-analysis
Paul R Burchard1, Raymond Lay2, Luis I Ruffolo1
1Departments of Surgery.
Insights
Glycerin suppositories and enemas may speed meconium evacuation in premature infants but do not impact mortality or feeding timelines. Clinical significance remains uncertain due to low-quality evidence.
Area of Science:
- Neonatalogy
- Gastroenterology
- Evidence-based medicine
Background:
- Premature infants often require interventions for meconium evacuation and enteral feeding transition.
- Glycerin suppositories and enemas are commonly used in neonatal care for these purposes.
Purpose of the Study:
- To review the best available evidence on the efficacy and safety of glycerin suppositories and enemas in premature infants.
- To evaluate the impact of these interventions on meconium evacuation, mortality, and enteral feeding initiation.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) published up to January 2022.
- Inclusion criteria: premature infants (<32 weeks gestation and/or <1500g birth weight) treated with glycerin suppositories or enemas.
- Data extraction and analysis using random effects models, reporting relative risk and mean difference.
Main Results:
- Six RCTs involving 389 premature infants were analyzed.
- No significant difference in mortality rates between glycerin suppositories and enemas (P = .86).
- Earlier meconium evacuation observed with active treatment (mean difference 1.5 days, P = .05), but no significant difference in time to enteral feeds (P = .48).
Conclusions:
- Glycerin suppositories and enemas facilitate earlier meconium evacuation in premature infants.
- The clinical significance of earlier meconium evacuation is uncertain.
- No definitive effects on mortality, necrotizing enterocolitis, or enteral feeding were established; evidence quality is low to moderate.
Background And Objectives:
Premature infants are often given glycerin suppositories or enemas to facilitate meconium evacuation and the transition to enteral feeds. We reviewed the best-available evidence for the use of glycerin suppositories and enemas in premature infants.
Methods:
We searched MEDLINE, Embase, and Cochrane Central for randomized controlled trials (RCTs) of premature infants treated with glycerin suppositories or enemas through January 2022. Studies were screened and data extracted independently and in duplicate. We included RCTs of premature infants <32 weeks gestation and/or birth weight <1500 g who were treated with glycerin suppositories or enemas. Meta-analysis was performed using random effects and reported as relative risk or mean difference.
Results:
We identified 6 single-center, RCTs of 389 premature infants treated with glycerin suppositories (n = 207) or enemas (n = 182). Mortality rates ranged from 0% to 17%, and the meta-analysis revealed no differences between treatment groups (P = .86). Active treatment was associated with earlier meconium evacuation (mean, 1.5 days; 95% confidence interval, 3.0 to 0.01; P = .05) but not a faster time to enteral feeds (mean, 0.5 days; P = .48). We identified 1 ongoing trial with a target recruitment of 220 premature infants. The quality of evidence was very low to moderate because of inadequate statistical power and other methodologic issues.
Conclusions:
The use of glycerin suppositories and enemas in premature infants is associated with earlier meconium evacuation, but the clinical significance of this finding is uncertain. Treatment has no definitive effects on mortality, necrotizing enterocolitis, or enteral feeds.
