Type of Delivery and Functional Constipation at 48 Months of Age: Cohort Study

Author(s): Analida Pinto Buelvas, Bianca Del Ponte, Alicia Matijasevich, Denise Marques, Rita Mattiello, Iná S Santos

Background: Several factors have been associated with childhood functional constipation; more recently, the type of delivery has been investigated. This study examined the association between cesarean section and constipation at 48 months of age in the 2004 birth cohort conducted in the city of Pelotas in Brazil.

Methods: Information on type of delivery (vaginal or cesarean) was extracted from medical records at the hospital of birth. Functional constipation was assessed by interviewing the mother in a 48-month follow-up assessment and was defined as the combination of at least two of the following symptoms in the last month: bowel movements ≤ 2 days/week, hard/scybalous stools, and difficult bowel movements. The prevalence of constipation according to delivery type was calculated. Crude and adjusted relative risks (95% confidence interval) were obtained by Poisson regression with robust variance.

Results: A total of 3,720 children were analyzed, 44.5% of whom were born via caesarean section. The prevalence of functional constipation was 17.1% (15.5-18.8%) among those born vaginally and 19.0% (17.2-21.0%) among those born via caesarean section. Reports of bowel movements ≤ 2 days/week were more frequent among those born vaginally (2.7% vs. 1.5%), while hard/scybalous stools (38.6% vs. 44.3%) and difficult bowel movements (21.7% vs. 25.1%) were more frequent among those born via cesarean section. In the adjusted analysis, there was no association between type of delivery and intestinal constipation (RR = 0.98; 0.84-1.15).

Conclusions: The prevalence of functional consti-pation was high at 48 months of age, and cesarean sections were not related to its occurrence.