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Constipation in very-low-birth-weight children at 10 to 14 years of age
C Cunningham1, H G Taylor, N M Minich
1Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, U.S.A. cxc55@po.cwru.edu
Insights
Very-low-birth-weight children (<750g) with constipation show higher rates of neurodevelopmental issues and toileting problems. Early intervention for constipation may reduce these complications in this vulnerable population.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Gastroenterology
Background:
- Very-low-birth-weight (VLBW) infants (<750g) exhibit elevated rates of neurosensory and cognitive impairments.
- Constipation is unexpectedly prevalent in VLBW children, affecting 32% of those studied.
- The high incidence of constipation warrants further investigation into its association with neurodevelopmental outcomes in VLBW children.
Purpose of the Study:
- To evaluate the prevalence and impact of constipation and associated toileting issues in VLBW children.
- To determine the relationship between constipation and neurodevelopmental impairments in VLBW children.
Main Methods:
- A case-control study matched 19 VLBW children with constipation to VLBW controls without constipation based on age, sex, and race.
- A telephone questionnaire was administered to parents of 15 constipated VLBW children and their matched controls.
Main Results:
- Constipated VLBW children had significantly higher rates of neurosensory impairment (47% vs. 7%) and lower mean IQ scores (72 vs. 89).
- Associated toileting problems, including encopresis (53% vs. 7%) and stool withholding (60% vs. 13%), were significantly more common in the constipated group.
Conclusions:
- Constipation in VLBW children is linked to neurodevelopmental impairments.
- Increased awareness and proactive interventions to promote regular bowel movements are crucial for mitigating constipation and related toileting problems in this population.
Background:
The authors documented that very-low-birth-weight children (less than 750-g) when compared with 750-to 1,499-g birth-weight and normal-birth-weight-matched controls have higher than normal rates of neurosensory and cognitive impairments at school age. In this population, the authors found a higher rate of constipation than expected among 19 of 59 (32%) less-than-750-g-birth-weight children. The authors therefore wanted to evaluate in greater detail the problem of constipation and associated toileting problems in this population.
Methods:
Nineteen less-than-750-g-birth-weight children with constipation were matched to the next less than 750-g-birth-weight child of comparable age, sex, and race who did not have constipation. A telephone questionnaire was administered to 15 of 19 parents of the less-than-750-g-birth-weight children who had constipation.
Results:
The 15 children with constipation had significantly higher rates of neurosensory impairment (7 [47%] vs. 1 [7%]) and lower mean WISC III IQ scores (72 +/- 22 vs. 89 +/- 13) when compared with birth-weight-matched controls without constipation (P < 0.05). The constipated children also had significantly higher rates of associated toileting problems, including encopresis (8[53%] vs. 1 [7%])and stool withholding (9 [60%] vs. 2 [13%]; P < 0.05).
Conclusion:
The higher incidence of constipation among less-than-750-g-birth-weight children is associated with neurodevelopment impairment. Awareness of this problem and preventive intervention to ensure regular stools could possibly decrease the high rate of constipation and associated toileting problems.
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