Risk factors for constipation during pregnancy: a multicentre prospective cohort study

Constipation is frequently encountered in the population of pregnant women. Physical activity and nutritional factors are considered common causes of constipation; however, their impact on this population has not yet been evaluated precisely. This study aimed to assess the prevalence of constipation and its risk factors during pregnancy and postpartum.

A prospective observational cohort study was conducted in 3 hospitals in Lithuania, including women with early viable pregnancies using questionnaires on demographic, obstetric, nutrition, behaviour, peri-anal disease, and birth data. All women with an early viable pregnancy (<12 weeks' gestation) aged 18 - 45 years who gave written informed consent were included. The Rome III criteria defined constipation. Independent risk factors were identified using multivariate analysis.

In all, 263 (55.9%) women developed constipation. Multivariate analysis identified haemorrhoidal disease during pregnancy (OR 8.25, 95% CI 4.41-15.4, p < 0.001), inadequate physical activity (OR 1.66, 95% CI 1.03-2.69, p=0.038), not participating in sports (OR 1.98, 95% CI 1.24-3.17, p=0.004), and monthly income 300-500 euros (OR 1.97, 95% CI 1.22-3.19, p=0.006) as significant predictors of constipation during pregnancy. Lower education was defined as a protective factor (retrospectively, secondary education by 2.2 times (OR 0.45, 95% CI 0.22-0.89, p=0.022) and unfinished secondary - by 1.84 times (OR 0.20, 95% CI 0.05-0.90, p=0.036) reduced the possibility of constipation development).

In conclusion, haemorrhoidal disease during pregnancy, low physical activity, and low monthly income are independent risk factors for constipation during pregnancy. Lower education significantly reduces the incidence of this condition.