Certified Pediatric Nurse (CPN)

Which condition does a neonate most likely have if they have not passed meconium 48 hours after birth?

1. Cystic fibrosis

2. Celiac disease

3. Intussusception

4. An abdominal defect

The correct answer is: Cystic fibrosis

In the context of a neonate not passing meconium within 48 hours after birth, cystic fibrosis is a condition that is strongly associated with this delayed passage. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system due to the production of thick and sticky mucus, which can lead to blockages in the intestines. In neonates, this can manifest as a failure to pass meconium as the thickened secretions obstruct the intestinal tract. Meconium ileus, a specific type of obstruction caused by thick meconium due to cystic fibrosis, is a classic presentation in newborns. If this condition is suspected, further evaluation, including a sweat chloride test, may be conducted to confirm cystic fibrosis. While other conditions like intestinal atresia or certain abdominal defects could also lead to failure to pass meconium, cystic fibrosis is the most common and classic underlying cause recognized in this scenario. Therefore, the association between cystic fibrosis and delayed meconium passage makes it the most likely diagnosis in this case.