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Association between cesarean section and constipation in infants: the Japan Environment and Children's Study (JECS)
Taketoshi Yoshida1, Kenta Matsumura2, Akiko Tsuchida2,3
1Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan. ytake@med.u-toyama.ac.jp.
Insights
Cesarean section (C-section) delivery does not significantly increase constipation risk in infants by age one, despite concerns about altered gut microbiota. This large study found no link between delivery mode and constipation prevalence.
Area of Science:
- Pediatrics
- Microbiome research
- Public health
Background:
- Cesarean section (C-section) is increasingly linked to infant diseases.
- C-section delivery may alter infant gut microbiota diversity.
- The impact of C-section on long-term infant health, including constipation, requires further investigation.
Purpose of the Study:
- To investigate the association between C-section delivery and the development of constipation at one year of age.
- To explore the role of altered gut microbiota in C-section-associated constipation.
- To analyze data from the Japan Environment and Children's Study (JECS) for insights into delivery mode and infant constipation.
Main Methods:
- Utilized data from a large cohort study (n=83,019) in the Japan Environment and Children's Study (JECS).
- Collected data on infant bowel movements and potential confounding factors.
- Employed a log-binomial regression model to estimate C-section risks, reporting risk ratios and 95% confidence intervals.
Main Results:
- Infants delivered by C-section had significantly lower gestational age and birth weight than vaginally delivered infants.
- Bowel movement frequency was similar between C-section and vaginally delivered infants.
- The overall prevalence of constipation was 1.37%, with no significant difference observed based on delivery mode (crude or adjusted).
Conclusions:
- Cesarean section delivery was not associated with an increased risk of constipation at one year of age in this cohort.
- Findings suggest that mode of delivery may not be a primary determinant of infant constipation.
- Further research is warranted to fully understand the long-term health implications of C-section on infant gut microbiota and related conditions.
Objective:
There have been increasing reports on the association between cesarean section (C-section) and the subsequent development of diseases in infants. C-section affects the diversity of microbiota in the infant's gut. In the present study, we investigated the association between infants delivered by C-section and the development of constipation at 1 year old due to altered gut microbiota using data from the Japan Environment and Children's Study (JECS).
Results:
This cohort study (n = 83,019) used data from JECS, an ongoing cohort study which began in January 2011. Data on bowel movement and potential confounding factors were recorded. A log-binomial regression model was used to estimate the risk of C-section, and the results were expressed as risk ratios and their respective 95% confidence intervals. Although infants delivered by C-section were of significantly younger gestational age and lesser birth weight than vaginally delivered infants, the frequency of bowel movements was almost similar between the two, independent of the mode of delivery. The prevalence of constipation in the entire infant was 1.37%. No significant differences were observed for C-section in crude and adjusted risk ratios for constipation.