Birth Weight Z-score and Placental Insufficiency as Predictors of Meconium-Related Ileus in Preterm Infants

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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

Genichiro Sotodate1, Atsushi Matsumoto1, Yukiko Toya1

  • 1Iwate Medical University, Department of Pediatrics, Iwate Prefecture, Japan, Shiwa District.

American Journal of Perinatology
|July 15, 2026
PubMed

Insights

Low birth weight Z-scores and low cerebroplacental ratio (CPR) are key risk factors for meconium-related ileus (MRI) in preterm infants. These indicators suggest placental insufficiency and fetal hypoxemia, guiding early intervention strategies.

Area of Science:

  • Neonatalogy
  • Perinatology
  • Pediatric Surgery

Background:

  • Neonatal intensive care advances improve survival for very-low-birth-weight infants.
  • Intestinal perforation remains a significant complication with poor outcomes.
  • Meconium-related ileus (MRI) is a common cause of intestinal issues in preterm infants, potentially leading to perforation.

Purpose of the Study:

  • To identify perinatal risk factors associated with meconium-related ileus (MRI) in preterm infants.
  • To investigate the relationship between fetal ultrasound findings and MRI development.

Main Methods:

  • Retrospective cohort study of 280 preterm infants (22-31 weeks gestation).
  • Comparison of clinical characteristics and fetal ultrasound data between infants with and without MRI.
  • Statistical analysis to determine independent risk factors and predictive values.

Main Results:

  • Infants with MRI had higher incidences of hypertensive disorders of pregnancy and non-reassuring fetal status.
  • Lower Z-scores for birth weight, height, and head circumference were observed in the MRI group.
  • Lower placental weight, umbilical artery pulsatility index, placental area, and cerebroplacental ratio (CPR) were associated with MRI.
  • Low birth-weight Z-score (OR: 0.57) and CPR were independent predictors of MRI.

Conclusions:

  • A low birth-weight Z-score and low CPR suggest placental insufficiency and fetal hypoxemia contribute to MRI pathogenesis.
  • These factors indicate poor intestinal motility as a likely mechanism.
  • Early, aggressive treatment with glycerin and gastrografin enemas may benefit infants with low birth-weight Z-scores and placental insufficiency.
Abstract

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