Meconium-Related Obstruction in Newborns occurs mostly without cystic fibrosis or Hirschsprung disease: JAMA
Researchers have found in a new study that contrary to popular belief nearly 95% of meconium-related obstruction (MRO) cases occur without cystic fibrosis or Hirschsprung disease. Further MRO is most common in preterm infants, who tend to have longer hospital stays and a higher likelihood of requiring surgical intervention. This study was conducted by Jordan M. published in the JAMA Network Open.
This retrospective cohort analysis used data from the National Inpatient Sample from January 1, 2016, through December 31, 2020. Survey weighting techniques were used to estimate the national incidence of MRO by etiology and to determine its relationship with clinical outcomes. The analysis included 3,550,796 live births, with emphasis on those with a diagnosis of MRO. The main outcome was the diagnosis of MRO, and secondary outcomes were mortality, requirement for abdominal surgery, hospital stay, and cost of hospitalization. Multivariable regression analysis was employed to determine characteristics linked to MRO and its clinical implications.
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
