Meconium-Related Obstruction in Newborns occurs mostly without cystic fibrosis or Hirschsprung disease: JAMA

Key Findings

• 1844 infants (0.1%) were treated for MRO.

• 41 (2.2%) of them had cystic fibrosis, 60 (3.3%) had Hirschsprung disease, and 1743 (94.5%) had neither.

Preterm infants presented with the highest risk, with:

• 4.7 cases of MRO per 100,000 births attributed to cystic fibrosis.

• 4.7 cases of MRO per 100,000 births attributed to Hirschsprung disease.

• 187.3 cases of MRO per 100,000 births in those without either condition.

• Newborn infants born at 28 to 31 weeks and 6 days gestation had the greatest chance of developing MRO, with an adjusted odds ratio (AOR) of 6.08 (95% CI, 4.27-8.67) as compared to full-term newborn infants.

• Among preterm newborn infants, having an MRO was correlated with:

• An increase in the demand for abdominal surgery by 4.2 percentage points (95% CI, 3.1-5.4).

• An additional hospital stay of 7.3 days (95% CI, 5.8-8.8 days).

• An additional cost of hospitalization of $23,215 (95% CI, $17,739-$28,690).

• No change in the rate of mortality (0.1 percentage point change [95% CI, -0.6 to 0.8]).

This study of more than 3.5 million infants concluded that MRO was highest in preterm infants without cystic fibrosis or Hirschsprung disease. These findings highlight the importance of better management strategies. Future studies must aim at establishing early diagnostic modalities and focused treatments to reduce the burden of MRO in susceptible neonates.

Reference:

Rook JM, Chervu N, Calkins KL, Benharash P, DeUgarte DA. Meconium-Related Obstruction and Clinical Outcomes in Term and Preterm Infants. JAMA Netw Open. 2025;8(2):e2459557. doi:10.1001/jamanetworkopen.2024.59557