Associação entre via de parto e constipação intestinal funcional aos 4 anos de idade : coorte de nascimentos de pelotas de 2004

Abstract

Introduction: Constipation is a functional disorder of the gastrointestinal tract. Several factors have been associated with functional constipation in childhood; a more recently investigated factor is the mode of delivery. Functional constipation and cesarean section are two conditions that have increased globally and nationally, the first having a negative impact on quality of life, and the second being associated with an increase in neonatal morbidity and mortality and, later, with diseases in childhood and adulthood. Thus, this study aims to investigate the association between type of delivery and prevalence of constipation at 4 years of age among children belonging to the 2004 Pelotas Birth Cohort. Methods: Population-based cohort study. Information on the type of delivery (vaginal or cesarean) was extracted from the medical records of the birth hospital. Functional constipation was assessed by interviewing the mother at a 48-month follow-up 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 the type of delivery 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, of which 44.5% were born by cesarean 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 by cesarean section. Reports of bowel movements ≤ 2 days/week were more frequent among those born vaginally (2.7% vs. 1.5%), while among those born by cesarean section hard/scybalous stools (44.3% vs. 38.6%) and difficult bowel movements (25.1% vs. 21.7%) were more frequent. In the adjusted analysis, there was no association between type of delivery and constipation (relative risk 0.98; 0.84-1.15). Conclusions: Cesarean birth was not related to the occurrence of functional constipation.