Meconium-related ileus in extremely low birthweight infants: Growth and neurodevelopmental outcomes.

PURPOSE: Meconium-related ileus (MRI) is a common gastrointestinal complication in extremely low birthweight infants (ELBWIs) that may delay enteral nutrition and adversely affect growth and neurodevelopment. This study aimed to determine the incidence of MRI in ELBWIs, identify associated clinical factors, and investigate short- and long-term impacts on growth and neurodevelopment outcomes.

METHODS

We retrospectively reviewed medical records of ELBWIs admitted to a single neonatal intensive care unit between January 2015 and August 2021. We investigated the prevalence of MRI and examined clinical features associated with MRI development by comparing patients with and without MRI. Additionally, we compared growth and neurodevelopmental outcomes among infants who completed at least 3 years of follow-up.

RESULTS

Among 108 ELBWIs, MRI was observed in 24 (22%) patients. Four patients developed intestinal perforation, resulting in two deaths. The other 20 cases (87%) were resolved with Gastrografin enema. Patients from twin pregnancies developed MRI more frequently than those from single pregnancies (p = 0.008). MRI patients had significantly longer time to establish enteral nutrition (21.5 days vs. 12 days, p < 0.001). No significant differences were observed in height or weight at corrected ages of 6, 12, 24, and 36 months between patients with and without MRI. There was no statistically significant difference in neurodevelopmental impairment rates at age 3 years.

CONCLUSIONS

While MRI was associated with delayed establishment of enteral nutrition, it did not demonstrate short- or long-term adverse effects on growth or neurodevelopment in ELBWIs.