Untersuchung des Stuhlverhaltens von Neugeborenen in Abhängigkeit von extrinsischen Faktoren (Kohorten Studie)

Investigation of Newborn Defecation Patterns in Relation to Extrinsic Factors (Cohort Study)

by Lars Brunckhorst
Doctoral thesis
Date of Examination:2025-02-11
Date of issue:2025-02-03
Advisor:Prof. Dr. Annegret Müller-Dornieden
Referee:PD Dr. Jana Katharina Dieks
Referee:Prof. Dr. Ralf Dressel
Persistent Address: http://dx.doi.org/10.53846/goediss-10977

 

 

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Abstract

English

Delayed meconium passage in preterm infants is common in very low birth weight infants, and there is evidence in the literature of a high risk of gastrointestinal complications, particularly in preterm infants of low gestational age. The aim of the present study was to investigate the influence of a number of extrinsic predictive factors on the defecation performance of newborns. For this purpose, we prospectively analyzed patient data collected over twelve months. The results indicate that there is no significant difference between female and male newborns with regard to the timing of meconium excretion and transitional defecation. Furthermore, newborns who passed their first transitional stool earlier than average were significantly heavier and taller than those in the late-excreting group. No significant associations were found between head circumference and the timing of meconium or transitional defecation. Further analysis of meconium data revealed that early meconium excreters had a significantly longer gestational duration compared to late-excreting newborns. This relationship was not significant concerning transitional defecation. Apgar scores showed no significant differences between early and late meconium excreting newborns. Nevertheless, a significant difference emerged after five minutes for transitional defecation, suggesting that newborns with initially higher Apgar scores passed their first transitional defecation significantly later. Early meconium excreting infants demonstrated significantly lower umbilical cord blood pH values postnatally. No significant correlations were found with body temperature or duration of birth. Interestingly, early excreting newborns of meconium and transitional defecation were significantly more likely to be born naturally, while late excreting infants were more often delivered via cesarean section at above-average rates. Parity and the timing of defecation showed a near-significant association (p = 0.077). No significant relationships were identified between postpartum nutrition, maternal pregnancy behaviors involving intoxicants, or birth outcomes. However, mothers of infants with early meconium and transitional defecation gained significantly more weight during pregnancy compared to the late-excreting group. Additionally, mothers of early meconium excreting infants were statistically younger. Finally, no significant correlations were observed between the timing of meconium and transitional defecation. Our findings suggest that specific predictive factors are associated with the timing of meconium or transitional defecation. Future large-scale, multicenter prospective studies are needed to validate these factors in combination with clinical symptoms to develop risk-stratification algorithms and enable early identification of at-risk patients.
Keywords: Newborns; Stool patterns; Defecation timing; Meconium passage; Gastrointestinal complications; Extrinsic factors; Risk stratification
 
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