Timing of passage of first urine and meconium after birth in newborns delivered at a tertiary-care health center in Eastern India

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Most neonates usually pass first urine and meconium within 24 and 48 hours of birth respectively. Delayed passage of urine and stool is considered a pointer of gastrointestinal/ genitourinary structural or motility disorder and are a cause of worry for parents. There is a lack of studies in Indian babies. Also, previous studies have relied on mother’s recall of the event. Therefore, through this study, we embarked to identify the timing of passage of first urine and stool in newborns delivered at our center by reviewing their input/output charts. Methodology: This was a single-center, cross-sectional study conducted after obtaining IEC approval at a tertiary-care health center in Eastern India. The eligible newborns delivered in labour room/OT of AIIMS, were prospectively enrolled observed. Result: Approximately two third newborns passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. The median time of passage of first urine was 4 [95% C.I. 1-7] hours of life. The median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male [5 (6), (p= 0.036)] and preterm new born [6.3 (9), (p= 0.001)]. Conclusion: Median time of passage of first urine was 4 [1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories. Median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male baby and preterm new born but no difference across the birth weight categories of the newborns. Infant Newborn Gastrointestinal Motility Urination Gestational Age Birth Weight Figures Figure 1 Introduction Meconium, the first gastrointestinal discharge of a neonate is black or greenish black in color, and thick and sticky in nature. It is composed of water and inorganic elements, enzymes, plasma proteins, glycoproteins, lipids, hemoglobin metabolites, steroids, bile acids and sterols [1]. Passage of meconium usually continues for 3-4 days after which it is followed by transitional stool, which are in turn replaced by regular stool within 1 to 2 days [2]. Most newborns usually pass first urine and meconium within 24 and 48 hours of birth respectively. Delayed passage of urine and stool is a cause of worry for parents. It may direct neonatologists towards many clinical conditions ranging from medical problems (inadequate feeding of the new-born, neonatal sepsis, hypothyroidism, perinatal asphyxia) to surgical conditions (urinary or gastrointestinal tract anomalies). Some of these clinical conditions may be otherwise missed on routine clinical examination. The timing of first urine and meconium by a new-born was probably studied for the first time by Sherry et al. in 1955 [3]. They studied 500 newborns and found that 17-27% newborns passed urine and meconium in the delivery room itself, and 3 and 1 newborns respectively passed their first urine and meconium after 48 hours. Later, Clark et al also studied 500 newborns and reported similar findings [4]. Delayed passage of meconium has been considered a sign of obstructive gastrointestinal disorders and has been viewed seriously but the cut off for definition and initiation of investigations have been considered at 48 hours. Since then, many researchers have studied the timing of first urine and meconium in newborns especially from Nigeria and China [5,6,13]. They have all validated previous findings that 48 hours may be kept a cut-off for delayed passage of urine and stool. As shown in study by Chin et al. in 1000 Chinese newborns 99.9 percent passed meconium within 48 hours thus signifying this cut off having very high specificity and positive predictive value however at the same time such a long cut off time means missing the opportunity of early investigations and intervention if needed. Several factors have been studied that may influence delayed passage of urine and meconium. It has been found that mode of delivery, prematurity, low birth weight, Apgar at 1 minute and number of feeds in 24 hours are significantly associated with delayed passage of first urine and meconium [7–9]. Studies have also reported that racial differences, maternal age, gender of baby, type of feeding, maternal use of narcotics do not play a role in this delay [7,8]. Previous studies have discovered an inverse relationship between gestation, birth weight and timing of passage of first meconium in a new-born [10,11]. A study from Bangladesh has also reported that though all neonates pass meconium within 48 hours, the timing is significantly delayed in babies with lower gestational age [12]. A cross-sectional study of Chinese newborns reported 2% prevalence of delayed passage of first stool in newborns with birth weight >2500 grams compared to 11.3% delayed passage in low birth weight new-borns [13]. The exact reason for this delay is unclear though it has been hypothesized to be due to delayed maturation of recto-inhibitory reflex [14]. There is however a lack of studies in Indian babies. Also, previous studies have relied on the mother's recall of the event. Therefore, through this study, we tried to objectively identify the timing of passage of first urine and stool in newborns delivered at our center by reviewing their input/output charts. We also wanted to answer the research question that what can be considered as delayed passage in our population? We also hope to determine factors like gender, gestation, birth weight affecting the timing of passage of first urine and meconium in newborns. Methods Study Design: This was a single-center, cross-sectional study conducted at a tertiary-care health center in Eastern India. IEC approval was obtained vide letter number AIIMS/Pat/IEC/2021/771 dated 24.08.2021. Inclusion criteria: All newborns delivered in the labor room/O.T. of All India Institute of Medical Sciences Patna. Exclusion criteria : Babies born with congenital anomalies Whose APGAR score <4 at 1 minute Sick babies requiring NICU admission Health records that are incomplete were excluded from the study. Sample Size: - Ezomike et al have reported 6.6% prevalence of delayed passage of meconium in newborns with birth weight >2500 grams compared to 34% delayed passage in low birth weight newborns.[8] Thus, assuming that 7% of the subjects in the reference population (babies with birth weight >2500 grams) and 34% LBW babies have delayed meconium passage; and after applying continuity correction, the study would require a sample size of 29 for LBW newborns and 290 for the reference group (i.e. a total sample size of 319; to ensure that the reference group is 10 times larger than the test group) to achieve a power of 80% for detecting a difference in proportions of 0.27 between the two groups (test - reference group) at a two sided p-value of 0.05 [15]. Statistical analysis: The collected data was entered in MS Excel sheet and analysis was performed using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21.0 software and epi info software version 7.2.3.1. Descriptive analyses were done to describe the characteristics, birth details and time of passage of first urine and meconium. The continuous variables were first checked for normality and accordingly presented as mean (SD) or median (IQR). Whereas, the categorical variables were expressed as proportions. The median time of passage of first urine and meconium was compared across gender, gestation and birth weight by applying non-parametric tests such as Mann- Whitney U test and Kruska wallis test. Results Study Design: This was a single-center, cross-sectional study conducted at a tertiary-care health center in Eastern India. IEC approval was obtained vide letter number AIIMS/Pat/IEC/2021/771 dated 24.08.2021. Inclusion criteria: All newborns delivered in the labor room/O.T. of All India Institute of Medical Sciences Patna. Exclusion criteria : Babies born with congenital anomalies Whose APGAR score <4 at 1 minute Sick babies requiring NICU admission Health records that are incomplete were excluded from the study. Sample Size: - Ezomike et al have reported 6.6% prevalence of delayed passage of meconium in newborns with birth weight >2500 grams compared to 34% delayed passage in low birth weight newborns.[8] Thus, assuming that 7% of the subjects in the reference population (babies with birth weight >2500 grams) and 34% LBW babies have delayed meconium passage; and after applying continuity correction, the study would require a sample size of 29 for LBW newborns and 290 for the reference group (i.e. a total sample size of 319; to ensure that the reference group is 10 times larger than the test group) to achieve a power of 80% for detecting a difference in proportions of 0.27 between the two groups (test - reference group) at a two sided p-value of 0.05 [15]. Statistical analysis: The collected data was entered in MS Excel sheet and analysis was performed using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21.0 software and epi info software version 7.2.3.1. Descriptive analyses were done to describe the characteristics, birth details and time of passage of first urine and meconium. The continuous variables were first checked for normality and accordingly presented as mean (SD) or median (IQR). Whereas, the categorical variables were expressed as proportions. The median time of passage of first urine and meconium was compared across gender, gestation and birth weight by applying non-parametric tests such as Mann- Whitney U test and Kruska wallis test. Results A total of 330 newborns were included in the study. There were 144 (43.6%) females and 186 (56.4%) males. The mean birth weight was 2.76 kg (SD = 0.56). Almost three fourth babies (75.8%) were born with birth weight appropriate for gestational age and only 3 (10 %) had very low birth weight. Likewise, the majority i.e., 260 (78.8%) were delivered at term while 68 (20.6%) and only 2 (0.6%) were delivered preterm and post-term respectively [Table 1]. Characteristic Frequency Percentage (95% CI) Sex Female 144 43.6 (38.4- 49) Male 186 56.4 (50.9- 61.6) Birth weight AGA 250 75.8 (70.9- 80.1) LBW 70 21.2 (17.2- 30) VLBW 10 3 (1.6- 6) Gestational at birth Term 260 78.8 (74.1- 82.9) Preterm 68 20.6 (16.6-25.3) Post-term 2 0.6 (0.2- 2.2) Mode of delivery NVD 88 26.8 (22.3- 31.8) LSCS 241 73.2 (68.2-77.7) Table 1: Clinico-demographic characteristic of new-borns in the study Liquor Meconium stained 34 10.3(7.5- 14.1) Not meconium stained 296 89.7(85.9-92.5) Cried after birth CIAB 286 87.2(83.1-90.3) Stimulation 20 6.1(3.9-9.2) PPV 22 6.7(4.4-9.9) Apgar at 1 minute 4-6 22 6.7(4.5-9.9) 7-9 307 93.3(90.1-95.5) PPV duration(second) <30 3 13.6(2.9-34.9) 30-60 10 45.4(24.3-67.7) 60-120 9 40.9(20.7-63.6) Figure 1 shows the maternal risk factors in the study. As many as half of the mothers i.e. 173 (52.4%) did not have any risk factor. Furthermore, maximum i.e., 60 (18.2%) reported having hypothyroidism followed by COVID- 19 infection 39 (11.8%), and gestational DM 26 (7.9%). Approximately two third newborns passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. Moreover, passage of first urine and meconium beyond 24 hours was noted for only 2 and 4 newborns respectively [Table 2]. Table 2: Distribution of new-borns as per the passage of urine and meconium (hours of life) Passage of urine (hours) [n= 330] Frequency Percentage (95% CI) 0- 6 230 69.7 (64.5- 74.4) 6.1- 12 62 18.7 (15- 23.3) 12.1- 24 36 (8- 14.7) >24.1 2 0.6 (0.2- 2.2) Passage of meconium (hours) [n= 327] 0- 6 205 62.7 (57.3- 67.8) 6.1- 12 86 26.3 (21.8- 31.3) 12.1- 24 32 9.8 (7- 13.5) >24.1 4 1.2 (0.5- 3.1) However no baby has passed urine after 48 hours. The maximum time taken was 28 hours for urine and 39 hours for meconium. The median time of passage of first urine was 4 [95% C.I. 1-7] hours of life; which was not influenced by the gender (p value= 0.325), gestational age at birth (p value= 0.338) and birth weight categories (p value= 0.22) of newborns under study [Table 3]. While on the other hand, the median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male [5 (6), (p= 0.036)] and preterm newborn [6.3 (9), (p= 0.001)] [Table 3]. However, no statistically significant difference in median time of passage of meconium was noted across the birth weight categories of the newborns [Table 3]. Table 3. Comparison of passage of first urine and meconium (median hours of life) across gender, gestation and birth weight category Characteristics Passage of first urine [Median hours of life (IQR)] Test statistics (p value) Passage of meconium [Median hours of life (IQR)] Test statistics (p value) Gender (n= 330) 0.984 (0.325) Mann-Whitney U test -2.092 (0.036) ** Mann-Whitney U test Female 3.5 (6) 3.2 (7) Male 4 (6) 5 (6) Gestational at birth * (n= 328) -0.959 (0.338) Mann-Whitney U test -3.369 (0.001) ** Mann-Whitney U test Term 4 (6) 3.5 (7) Preterm 3.7 (6) 6.3 (9) Birth weight category (n= 330) 3.03 (0.22) Kruskal wallis test 0.578 (0.749) Kruskal wallis test AGA 3.9 (6) 4 (8) LBW 4 (4) 5 (7) VLBW 1.5 (9) 6 (11) *As only 2 new-borns belonged to post term gestation category, it was not considered in the analysis. **p value is significant Discussion Our study showed that an overwhelming majority of neonates passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery and 99.39 % passed urine & 98.77 % meconium within 24 hours. It has been found that mode of delivery, prematurity, low birth weight, Apgar at 1 minute and number of feeds in 24 hours are significantly associated with delayed passage of first urine and meconium [7–9]. Our study showed the median time of passage of first urine was 4 [95% C.I. 1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories i.e. AGA, LBW, and VLBW. It is in contrast to previous studies that discovered an inverse relationship between gestation, birth weight and timing of passage of first meconium in a new-born [10, 11]. The study done in India in 1987 by Jhaveri MK and Kumar SP had shown delayed passage of meconium in 20% VLBW babies [12], which is very much in contrast with our study. It may be due to our practice of initiating breastfeeding within the first hour of life. A study from Bangladesh has also reported that though all neonates pass meconium within 48 hours, the timing is significantly delayed in babies with lower gestational age [13]. We too found in our study that the median time of passage of meconium was 4 [95% C.I. 1-8] hours of life, which was significantly higher for male baby and preterm newborn. While one study from China showed that the prevalence of delayed passage of the first stool in newborns with birth weight >2500 grams was 2% compared to 11.3% delayed passage in low birth weight newborns [14]. However in our study no statistically significant difference in median time of passage of meconium was noted across the birth weight categories of the newborns. With a lot of development in neonatology and with early initiation of breastfeeding/EBM feeding over the last few decades, the passage of urine and meconium has become almost universal within the first 24 hours. So now the cut off limit for the passage of meconium and urine should be considered 24 hours and not 48 hours. This may increase the likelihood of early identification and intervention in gastrointestinal structural or motility disorders. Conclusion: Median time of passage of first urine was 4 [1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories. Median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male baby and preterm newborns but no difference across the birth weight categories of the newborns. As the statistically more than 97 percent of babies pass meconium and urine within 24 hours of birth, now the cut off limit for the passage of meconium and urine should be considered 24 hours and not 48 hours. This may increase the likelihood of early identification and intervention in gastrointestinal structural or motility disorders. Limitations of this study Timing of passage of first urine and meconium (in hours after birth) was recorded from input/output charts maintained by nursing officers. Absolute duration of timing from birth may have some error. To overcome this limitation, comparative statistical analysis was also run by converting this metric variable into an ordinal variable (within 12 hours, 12-24 hours, 24-48 hours). This study was conducted on newborns delivered at a tertiary-care center in Eastern India. Larger population-based studies will be required to extrapolate the findings to the general population. Declarations Statement of Ethics Study approval statement : This study protocol was reviewed and approved by the Institutional Ethics Committee, AIIMS Patna, approval number AIIMS/Pat/IEC/2021/771 dated 24/08/2021 Consent to participate statement : Written informed consent was obtained from parent to participate in the study. Conflict of Interest Statement-The authors have no conflicts of interest to declare. Funding Sources-None References Haram-Mourabet S, Harper RG, Wapnir RA. Mineral Composition of Meconium. J Am Coll Nutr. Taylor & Francis; 1998;17:356–60. Weaver LT, Lucas A. Development of bowel habit in preterm infants. Arch Dis Child. 1993;68:317–20. Sherry SN, Kramer I. The time of passage of the first stool and first urine by the newborn infant. J Pediatr. Elsevier; 1955;46:158–9. Clark DA. Times of first void and first stool in 500 newborns: Nurs Res. 1978;27:139. Okoro PE, Enyindah CE. Time of passage of First Stool in Newborns in a Tertiary Health Facility in Southern Nigeria. Niger J Surg Off Publ Niger Surg Res Soc. 2013;19:20–2. Ameh N, Ameh EA. Timing of passage of first meconium and stooling pattern in normal Nigerian newborns. Ann Trop Paediatr. 2009;29:129–33. Metaj M, Laroia N, Lawrence RA, Ryan RM. Comparison of Breast- and Formula-Fed Normal Newborns in Time to First Stool and Urine. J Perinatol. 2003;23:624–8. Ezomike UO, Ugwu EO, Ezomike NE, Eke CB, Ekenze SO. Evaluation of Impact of Perinatal Factors on Time to First Meconium Passage in Nigerian Neonates. Malawi Med J. 2019;31:150–4. Vuohelainen T, Ojala R, Virtanen A, Holm P, Tammela O. Predictors of delayed first voiding in newborn. Acta Paediatr. 2008;97:904–8. Verma A, Dhanireddy R. Time of first stool in extremely low birth weight (≤ 1000 grams) infants. J Pediatr. Elsevier; 1993;122:626–9. Wang P-A, Huang F-Y. Time of the first defecation and urination in very low birth weight infants. Eur J Pediatr. 1994;153:279–83. Jhaveri MK, Kumar SP. Passage of the first stool in very low birth weight infants. Pediatrics. 1987 Jun;79(6):1005–7. Setu M, Mollah MAH, Amin SK, Morshed SMN, Pervez M, Akhter A. Duration of Meconium Passage in Term and Preterm Infants. Anwer Khan Mod Med Coll J. 2013;4:6–9. Chih T, Teng R, Wang C, Tsou Yau K. Time of the first urine and the first stool in Chinese newborns. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991;32:17–23. Lorijn F de, Voskuijl WP, Omari TI, Kok JH, Taminiau JAJM, Benninga MA. Assessment of the Rectoanal Inhibitory Reflex in Preterm Infants with Delayed Meconium Passage: J Pediatr Gastroenterol Nutr. 2005;40:434–7. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1830343","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":121554159,"identity":"02d18df7-aa7d-43dd-9a0f-fc23ac682621","order_by":0,"name":"Bhabesh Kant Chowdhry","email":"","orcid":"","institution":"All India Institute of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Bhabesh","middleName":"Kant","lastName":"Chowdhry","suffix":""},{"id":121554160,"identity":"2644ed50-17ca-4379-af37-c897b946e560","order_by":1,"name":"Chandra Mohan 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07:59:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1830343/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1830343/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":24058923,"identity":"595618e7-37cc-4e0c-9577-02a6c708dfcb","added_by":"auto","created_at":"2022-07-19 19:41:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60039,"visible":true,"origin":"","legend":"\u003cp\u003e See image above for figure legend.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-1830343/v1/77d8356c2ed63c1c3b03bddd.png"},{"id":25205991,"identity":"54ff05d3-c761-412f-96fa-02bfcdd22661","added_by":"auto","created_at":"2022-08-15 08:29:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":424214,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1830343/v1/35c58739-36f0-43b2-a28e-b59f7433d988.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Timing of passage of first urine and meconium after birth in newborns delivered at a tertiary-care health center in Eastern India","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMeconium, the first gastrointestinal discharge of a neonate is black or greenish black in color, and thick and sticky in nature. It is composed of water and inorganic elements, enzymes, plasma proteins, glycoproteins, lipids, hemoglobin metabolites, steroids, bile acids and sterols [1]. Passage of meconium usually continues for 3-4 days after which it is followed by transitional stool, which are in turn replaced by regular stool within 1 to 2 days [2]. Most newborns usually pass first urine and meconium within 24 and 48 hours of birth respectively. Delayed passage of urine and stool is a cause of worry for parents. It may direct neonatologists towards many clinical conditions ranging from medical problems (inadequate feeding of the new-born, neonatal sepsis, hypothyroidism, perinatal asphyxia) to surgical conditions (urinary or gastrointestinal tract anomalies). Some of these clinical conditions may be otherwise missed on routine clinical examination.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe timing of first urine and meconium by a new-born was probably studied for the first time by Sherry et al. in 1955 [3]. They studied 500 newborns and found that 17-27% newborns passed urine and meconium in the delivery room itself, and 3 and 1 newborns respectively passed their first urine and meconium after 48 hours. Later, Clark et al also studied 500 newborns and reported similar findings [4]. Delayed passage of meconium has been considered a sign of obstructive gastrointestinal disorders and has been viewed seriously but the cut off for definition and initiation of investigations have been considered at 48 hours. Since then, many researchers have studied the timing of first urine and meconium in newborns especially from Nigeria and China [5,6,13]. They have all validated previous findings that 48 hours may be kept a cut-off for delayed passage of urine and stool. As shown in study by Chin et al. in 1000 Chinese newborns 99.9 percent passed meconium within 48 hours thus signifying this cut off having very high specificity and positive predictive value however at the same time such a long cut off time means missing the opportunity of early investigations and intervention if needed. Several factors have been studied that may influence delayed passage of urine and meconium. It has been found that mode of delivery, prematurity, low birth weight, Apgar at 1 minute and number of feeds in 24 hours are significantly associated with delayed passage of first urine and meconium [7\u0026ndash;9]. Studies have also reported that racial differences, maternal age, gender of baby, type of feeding, maternal use of narcotics do not play a role in this delay [7,8]. Previous studies have discovered an inverse relationship between gestation, birth weight and timing of passage of first meconium in a new-born [10,11]. A study from Bangladesh has also reported that though all neonates pass meconium within 48 hours, the timing is significantly delayed in babies with lower gestational age [12]. A cross-sectional study of Chinese newborns reported 2% prevalence of delayed passage of first stool in newborns with birth weight \u0026gt;2500 grams compared to 11.3% delayed passage in low birth weight new-borns [13]. The exact reason for this delay is unclear though it has been hypothesized to be due to delayed maturation of recto-inhibitory reflex [14].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is however a lack of studies in Indian babies. Also, previous studies have relied on the mother\u0026apos;s recall of the event. Therefore, through this study, we tried to objectively identify the timing of passage of first urine and stool in newborns delivered at our center by reviewing their input/output charts. We also wanted to answer the research question that what can be considered as delayed passage in our population? We also hope to determine factors like gender, gestation, birth weight affecting the timing of passage of first urine and meconium in newborns.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design: This was a single-center, cross-sectional study conducted at a tertiary-care health center in Eastern India. IEC approval was obtained vide letter number AIIMS/Pat/IEC/2021/771 dated 24.08.2021.\u003c/p\u003e\n\u003cp\u003eInclusion criteria:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll newborns delivered in the labor room/O.T. of All India Institute of Medical Sciences Patna.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Exclusion criteria :\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBabies born with congenital anomalies\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhose APGAR score \u0026lt;4 \u0026nbsp;at 1 minute\u003c/p\u003e\n\u003cp\u003eSick babies requiring NICU admission\u003c/p\u003e\n\u003cp\u003eHealth records that are incomplete were excluded from the study.\u003c/p\u003e\n\u003cp\u003eSample Size: -\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEzomike et al have reported 6.6% prevalence of delayed passage of meconium in newborns with\u003c/p\u003e\n\u003cp\u003ebirth weight \u0026gt;2500 grams compared to 34% delayed passage in low birth weight newborns.[8]\u003c/p\u003e\n\u003cp\u003eThus, assuming that 7% of the subjects in the reference population (babies with birth weight \u0026gt;2500\u003c/p\u003e\n\u003cp\u003egrams) and 34% LBW babies have delayed meconium passage; and after applying continuity\u003c/p\u003e\n\u003cp\u003ecorrection, the study would require a sample size of 29 for LBW newborns and 290 for the\u003c/p\u003e\n\u003cp\u003ereference group (i.e. a total sample size of 319; to ensure that the reference group is 10 times larger\u003c/p\u003e\n\u003cp\u003ethan the test group) to achieve a power of 80% for detecting a difference in proportions of 0.27\u003c/p\u003e\n\u003cp\u003ebetween the two groups (test - reference group) at a two sided p-value of 0.05 [15].\u003c/p\u003e\n\u003cp\u003eStatistical analysis:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe collected data was entered in MS \u0026nbsp; Excel \u0026nbsp;sheet \u0026nbsp;and \u0026nbsp; analysis \u0026nbsp;was \u0026nbsp;performed using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21.0 software and epi info software version 7.2.3.1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDescriptive analyses were done to describe the characteristics, birth details and time of passage of first urine and meconium. The continuous variables were first checked for normality and accordingly presented as mean (SD) or median (IQR). Whereas, the categorical variables were expressed as proportions. The median time of passage of first urine and meconium was compared across gender, gestation and birth weight by applying non-parametric tests such as Mann- Whitney U test and Kruska wallis test.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eStudy Design: This was a single-center, cross-sectional study conducted at a tertiary-care health center in Eastern India. IEC approval was obtained vide letter number AIIMS/Pat/IEC/2021/771 dated 24.08.2021.\u003c/p\u003e\n\u003cp\u003eInclusion criteria:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll newborns delivered in the labor room/O.T. of All India Institute of Medical Sciences Patna.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Exclusion criteria :\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBabies born with congenital anomalies\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhose APGAR score \u0026lt;4 \u0026nbsp;at 1 minute\u003c/p\u003e\n\u003cp\u003eSick babies requiring NICU admission\u003c/p\u003e\n\u003cp\u003eHealth records that are incomplete were excluded from the study.\u003c/p\u003e\n\u003cp\u003eSample Size: -\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEzomike et al have reported 6.6% prevalence of delayed passage of meconium in newborns with\u003c/p\u003e\n\u003cp\u003ebirth weight \u0026gt;2500 grams compared to 34% delayed passage in low birth weight newborns.[8]\u003c/p\u003e\n\u003cp\u003eThus, assuming that 7% of the subjects in the reference population (babies with birth weight \u0026gt;2500\u003c/p\u003e\n\u003cp\u003egrams) and 34% LBW babies have delayed meconium passage; and after applying continuity\u003c/p\u003e\n\u003cp\u003ecorrection, the study would require a sample size of 29 for LBW newborns and 290 for the\u003c/p\u003e\n\u003cp\u003ereference group (i.e. a total sample size of 319; to ensure that the reference group is 10 times larger\u003c/p\u003e\n\u003cp\u003ethan the test group) to achieve a power of 80% for detecting a difference in proportions of 0.27\u003c/p\u003e\n\u003cp\u003ebetween the two groups (test - reference group) at a two sided p-value of 0.05 [15].\u003c/p\u003e\n\u003cp\u003eStatistical analysis:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe collected data was entered in MS \u0026nbsp; Excel \u0026nbsp;sheet \u0026nbsp;and \u0026nbsp; analysis \u0026nbsp;was \u0026nbsp;performed using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21.0 software and epi info software version 7.2.3.1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDescriptive analyses were done to describe the characteristics, birth details and time of passage of first urine and meconium. The continuous variables were first checked for normality and accordingly presented as mean (SD) or median (IQR). Whereas, the categorical variables were expressed as proportions. The median time of passage of first urine and meconium was compared across gender, gestation and birth weight by applying non-parametric tests such as Mann- Whitney U test and Kruska wallis test.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults\u003c/p\u003e\n\u003cp\u003eA total of 330 newborns were included in the study. There were 144 (43.6%) females and 186 (56.4%) males. The mean birth weight was 2.76 kg (SD = 0.56). Almost three fourth babies (75.8%) were born with birth weight appropriate for gestational age and only 3 (10 %) had very low birth weight. Likewise, the majority i.e., 260 (78.8%) were delivered at term while 68 (20.6%) and only 2 (0.6%) were delivered preterm and post-term respectively [Table 1]. \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"100%\"\u003e\n \u003ctable align=\"left\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e43.6 (38.4- 49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;56.4 (50.9- 61.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003eAGA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e75.8 (70.9- 80.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003eLBW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;21.2 (17.2- 30)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003eVLBW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"53.51882160392799%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 3 (1.6- 6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational at birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003eTerm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e78.8 (74.1- 82.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003ePreterm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e20.6 (16.6-25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003ePost-term\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e0.6 (0.2- 2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNVD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e26.8 (22.3- 31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"26.350245499181668%\"\u003e\n \u003cp\u003eLSCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.130932896890343%\"\u003e\n \u003cp\u003e241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.53682487725041%\"\u003e\n \u003cp\u003e73.2 (68.2-77.7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0.9819967266775778%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1: Clinico-demographic characteristic of new-borns in the study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiquor\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMeconium stained \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;34 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;10.3(7.5- 14.1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNot meconium stained \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;296 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;89.7(85.9-92.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCried after birth\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eCIAB \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;286 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;87.2(83.1-90.3)\u003c/p\u003e\n \u003cp\u003eStimulation \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 6.1(3.9-9.2)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePPV \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;22 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6.7(4.4-9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eApgar at 1 minute\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e4-6 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 22 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6.7(4.5-9.9)\u003c/p\u003e\n \u003cp\u003e7-9 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 307 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 93.3(90.1-95.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePPV duration(second)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;30 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 3 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;13.6(2.9-34.9)\u003c/p\u003e\n \u003cp\u003e30-60 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;10 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;45.4(24.3-67.7)\u003c/p\u003e\n \u003cp\u003e60-120 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;9 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;40.9(20.7-63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFigure 1 shows the maternal risk factors in the study. As many as half of the mothers i.e. 173 (52.4%) did not have any risk factor. Furthermore, maximum i.e., 60 (18.2%) reported having hypothyroidism followed by COVID- 19 infection 39 (11.8%), and gestational DM 26 (7.9%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eApproximately two third newborns passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. Moreover, passage of first urine and meconium beyond 24 hours was noted for only 2 and 4 newborns respectively [Table 2].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Distribution of new-borns as per the passage of urine and meconium (hours of life)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Passage of urine (hours)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; [n= 330]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0- 6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.7 (64.5- 74.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e6.1- 12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18.7 (15- 23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e12.1- 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003col\u003e\n \u003cli\u003e(8- 14.7)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.6 (0.2- 2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePassage of meconium (hours)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e[n= 327]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0- 6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62.7 (57.3- 67.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e6.1- 12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e26.3 (21.8- 31.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e12.1- 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.8 (7- 13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.2 (0.5- 3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eHowever no baby has passed urine after 48 hours. The maximum time taken was 28 hours for urine and 39 hours for meconium.\u003c/p\u003e\n\u003cp\u003eThe median time of passage of first urine was 4 [95% C.I. 1-7] hours of life; which was not influenced by the gender (p value= 0.325), gestational age at birth (p value= 0.338) and birth weight categories (p value= 0.22) of newborns under study [Table 3]. While on the other hand, the median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male [5 (6), (p= 0.036)] and preterm newborn [6.3 (9), (p= 0.001)] [Table 3]. However, no statistically significant difference in median time of passage of meconium was noted across the birth weight categories of the newborns [Table 3].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Comparison of passage of first urine and meconium (median hours of life) across gender, gestation and birth weight category\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.1875%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.125%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePassage of first urine\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e[Median hours of life (IQR)]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.28125%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest statistics (p value)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.53125%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePassage of meconium\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e[Median hours of life (IQR)]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.875%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest statistics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(p value)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.1875%\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender (n= 330)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"18.28125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.984 (0.325)\u003c/p\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.53125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"21.875%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-2.092 (0.036) **\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e3.5 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e3.2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e5 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.1875%\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational at birth * (n= 328)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"18.28125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-0.959 (0.338)\u003c/p\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.53125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"21.875%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-3.369 (0.001) **\u003c/p\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eTerm \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e3.5 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003ePreterm \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e3.7 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e6.3 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.1875%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight category (n= 330)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"18.28125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.03 (0.22)\u003c/p\u003e\n \u003cp\u003eKruskal wallis test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.53125%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"21.875%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.578 (0.749)\u003c/p\u003e\n \u003cp\u003eKruskal wallis test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eAGA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e3.9 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e4 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eLBW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e4 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e5 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.0757180156658%\"\u003e\n \u003cp\u003eVLBW\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.287206266318538%\"\u003e\n \u003cp\u003e1.5 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.637075718015666%\"\u003e\n \u003cp\u003e6 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*As only 2 new-borns belonged to post term gestation category, it was not considered in the analysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e**p value is significant\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study showed that an overwhelming majority of neonates passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery and 99.39 % passed urine \u0026amp; 98.77 % meconium within 24 hours. It has been found that mode of delivery, prematurity, low birth weight, Apgar at 1 minute and number of feeds in 24 hours are significantly associated with delayed passage of first urine and meconium [7\u0026ndash;9]. Our study showed the median time of passage of first urine was 4 [95% C.I. 1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories i.e. AGA, LBW, and VLBW. It is in contrast to previous studies that discovered an inverse relationship between gestation, birth weight and timing of passage of first meconium in a new-born [10, 11]. The study done in India in 1987 by Jhaveri MK and Kumar SP had shown delayed passage of meconium in 20% VLBW babies [12], which is very much in contrast with our study. It may be due to our practice of initiating breastfeeding within the first hour of life. A study from Bangladesh has also reported that though all neonates pass meconium within 48 hours, the timing is significantly delayed in babies with lower gestational age [13]. \u0026nbsp;We too found in our study that the median time of passage of meconium was 4 [95% C.I. 1-8] hours of life, which was significantly higher for male baby and preterm newborn. While one study from China showed that the prevalence of delayed passage of the first stool in newborns with birth weight \u0026gt;2500 grams was 2% compared to 11.3% delayed passage in low birth weight newborns [14]. However in our study no statistically significant difference in median time of passage of meconium was noted across the birth weight categories of the newborns.\u003c/p\u003e\n\u003cp\u003eWith a lot of development in neonatology and with early initiation of breastfeeding/EBM feeding over the last few decades, the passage of urine and meconium has become almost universal within the first 24 hours. So now the cut off limit for the passage of meconium and urine should be considered 24 hours and not 48 hours. This may increase the likelihood of early identification and intervention in gastrointestinal structural or motility disorders.\u003c/p\u003e\n\u003cp\u003eConclusion: Median time of passage of first urine was 4 [1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories. Median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male baby and preterm newborns but no difference across the birth weight categories of the newborns. As the statistically more than 97 percent of babies pass meconium and urine within 24 hours of birth, \u0026nbsp;now the cut off limit for the passage of meconium and urine should be considered 24 hours and not 48 hours. This may increase the likelihood of early identification and intervention in gastrointestinal structural or motility disorders.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations of this study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Timing of passage of first urine and meconium (in hours after birth) was recorded from input/output charts maintained by nursing officers. Absolute duration of timing from birth may have some error. To overcome this limitation, comparative statistical analysis was also run by converting this metric variable into an ordinal variable (within 12 hours, 12-24 hours, 24-48 hours).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; This study was conducted on newborns delivered at a tertiary-care center in Eastern India. Larger population-based studies will be required to extrapolate the findings to the general population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eStatement of Ethics\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eStudy approval statement\u003c/u\u003e: \u003cem\u003eThis study protocol was reviewed and approved by the Institutional Ethics Committee, AIIMS Patna, approval number\u0026nbsp;\u003c/em\u003eAIIMS/Pat/IEC/2021/771 dated 24/08/2021\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eConsent to participate statement\u003c/u\u003e: Written informed consent was obtained from parent to participate in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConflict of Interest Statement-The authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003cp\u003eFunding Sources-None\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cspan\u003eHaram-Mourabet S, Harper RG, Wapnir RA. Mineral Composition of Meconium. J Am Coll Nutr. Taylor \u0026amp; Francis; 1998;17:356\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eWeaver LT, Lucas A. Development of bowel habit in preterm infants. Arch Dis Child. 1993;68:317\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eSherry SN, Kramer I. The time of passage of the first stool and first urine by the newborn infant. J Pediatr. Elsevier; 1955;46:158\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eClark DA. Times of first void and first stool in 500 newborns: Nurs Res. 1978;27:139.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eOkoro PE, Enyindah CE. Time of passage of First Stool in Newborns in a Tertiary Health Facility in Southern Nigeria. Niger J Surg Off Publ Niger Surg Res Soc. 2013;19:20\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eAmeh N, Ameh EA. Timing of passage of first meconium and stooling pattern in normal Nigerian newborns. Ann Trop Paediatr. 2009;29:129\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMetaj M, Laroia N, Lawrence RA, Ryan RM. Comparison of Breast- and Formula-Fed Normal Newborns in Time to First Stool and Urine. J Perinatol. 2003;23:624\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eEzomike UO, Ugwu EO, Ezomike NE, Eke CB, Ekenze SO. Evaluation of Impact of Perinatal Factors on Time to First Meconium Passage in Nigerian Neonates. Malawi Med J. 2019;31:150\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eVuohelainen T, Ojala R, Virtanen A, Holm P, Tammela O. Predictors of delayed first voiding in newborn. Acta Paediatr. 2008;97:904\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eVerma A, Dhanireddy R. Time of first stool in extremely low birth weight (\u0026le; 1000 grams) infants. J Pediatr. Elsevier; 1993;122:626\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eWang P-A, Huang F-Y. Time of the first defecation and urination in very low birth weight infants. Eur J Pediatr. 1994;153:279\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eJhaveri MK, Kumar SP. Passage of the first stool in very low birth weight infants. Pediatrics. 1987 Jun;79(6):1005\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eSetu M, Mollah MAH, Amin SK, Morshed SMN, Pervez M, Akhter A. Duration of Meconium Passage in Term and Preterm Infants. Anwer Khan Mod Med Coll J. 2013;4:6\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eChih T, Teng R, Wang C, Tsou Yau K. Time of the first urine and the first stool in Chinese newborns. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991;32:17\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eLorijn F de, Voskuijl WP, Omari TI, Kok JH, Taminiau JAJM, Benninga MA. Assessment of the Rectoanal Inhibitory Reflex in Preterm Infants with Delayed Meconium Passage: J Pediatr Gastroenterol Nutr. 2005;40:434\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Infant Newborn, Gastrointestinal Motility, Urination, Gestational Age, Birth Weight","lastPublishedDoi":"10.21203/rs.3.rs-1830343/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1830343/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Meconium is the first gastrointestinal discharge of a neonate. Most neonates usually pass first urine and meconium within 24 and 48 hours of birth respectively. Delayed passage of urine and stool is considered a pointer of gastrointestinal/ genitourinary structural or motility disorder and are a cause of worry for parents. There is a lack of studies in Indian babies. Also, previous studies have relied on mother’s recall of the event. Therefore, through this study, we embarked to identify the timing of passage of first urine and stool in newborns delivered at our center by reviewing their input/output charts.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethodology:\u003c/strong\u003e This was a single-center, cross-sectional study conducted after obtaining IEC approval at a tertiary-care health center in Eastern India. The eligible newborns delivered in labour room/OT of AIIMS, were prospectively enrolled observed.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResult: \u003c/strong\u003eApproximately two third newborns passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. The median time of passage of first urine was 4 [95% C.I. 1-7] hours of life. The median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male [5 (6), (p= 0.036)] and preterm new born [6.3 (9), (p= 0.001)].\u0026nbsp;\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u0026nbsp;Median time of passage of first urine was 4 [1-7] hours of life; which was not influenced by the gender, gestation at birth and birth weight categories. Median time of passage of meconium was 4 [1-8] hours of life, which was significantly higher for male baby and preterm new born but no difference across the birth weight categories of the newborns.\u003c/p\u003e","manuscriptTitle":"Timing of passage of first urine and meconium after birth in newborns delivered at a tertiary-care health center in Eastern India","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-07-19 19:41:51","doi":"10.21203/rs.3.rs-1830343/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c274389c-a03a-4021-9fde-c9e9f2191ae6","owner":[],"postedDate":"July 19th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-08-15T08:29:21+00:00","versionOfRecord":[],"versionCreatedAt":"2022-07-19 19:41:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1830343","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1830343","identity":"rs-1830343","version":["v1"]},"buildId":"oE6Zbj460LM0Up2FdVbMZ","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}