关键词: 婴儿排便困难, 肠道菌群, 抗生素, 危险因素, 胎粪, 16SrDNA测序

Abstract: Objective　To investigate the influencing factors of early intestinal flora on the occurrence of infant dyschezia by analyzing clinical characteristics and sequencing meconium samples collected within 72h after birth，so as to provide new insights for early intestinal intervention. Methods　Full-term neonates born at Shenzhen Maternity and Child Healthcare Hospital，Southern Medical University between January 2021 and April 2021 were enrolled. Clinical data were collected，and meconium samples were obtained within 72 h after birth. A questionnaire survey was completed by telephone follow-up at 3 months of age，and the infants suspected with dyschezia were recalled for hospital re-evaluation. Those meeting the RomeⅣ criteria were assigned to the infant dyschezia group，and the remaining infants were enrolled as the non-infant dyschezia group using propensity score matching at a ratio of 1︰4. Baseline clinical data were compared between the two groups，and analyze associated factors. In addition，another healthy control group were matched at a ratio of 1︰1 from the remaining cases using propensity score matching. The 16SrDNA sequencing was performed on the meconium samples of the two groups to compare differences in intestinal flora diversity，richness and community structure. Results　The incidence of infant dyschezia was 4.3%. The prophylactic antibiotics use during the neonatal period was significantly different between the infant dyschezia group and the non- infant dyschezia group（P<0.05）. Vaginal delivery and prophylactic antibiotic use during the neonatal period were risk factors for infant dyschezia. There were no significant differences in the diversity and richness of intestinal flora between the infant dyschezia group and the healthy control group（P>0.05）. However，statistically significant differences were found in community structure at the phylum level of Spirochaetes and the genus levels of Bacteroides between the two groups（P<0.05）. Conclusion　Vaginal delivery and prophylactic antibiotic use can increase the risk of developing infant dyschezia. No significant differences exist in the diversity and richness of early intestinal flora between the infants with dyschezia and the healthy infants in the postnatal period，whereas the relative abundance of Bacteroides at the genus level is significant higher than in healthy infants.

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