Meconium-related obstruction: Contemporary experience in a multi-institutional consortium

Area of Science:

• Neonatalogy
• Pediatric Surgery
• Gastroenterology

Background:

• Neonatal bowel obstruction due to inspissated meconium is historically linked to cystic fibrosis.
• Meconium-related obstruction (MRO) is increasingly recognized in preterm infants.

Purpose of the Study:

• To characterize the contemporary experience with MRO in a multicenter setting.
• To investigate factors associated with MRO treatment and outcomes.
• To explore provider perspectives on MRO management in preterm infants.

Main Methods:

• A retrospective cohort study of 105 infants with MRO across seven children's hospitals (2018-2022).
• Statistical analyses including chi-squared, Kruskal-Wallis, and logistic regression.
• A survey of 42 providers on MRO of prematurity management.

Main Results:

• Most MRO cases (51%) occurred in preterm infants; 26% of all infants required surgery, predominantly preterm infants (78%).
• Increased gestational age was associated with a decreased likelihood of surgery in preterm infants (OR=0.77).
• Provider surveys indicated a lack of standardized institutional treatment algorithms for MRO.

Conclusions:

• Prematurity is the leading factor in contemporary MRO cases.
• The degree of prematurity influences the need for surgical intervention.
• Findings support the development of a prevention and treatment algorithm for MRO of prematurity.