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Early-Life Factors Associated With Pediatric Functional Constipation

Turco, Rossella*; Miele, Erasmo*; Russo, Marina*; Mastroianni, Rossella*; Lavorgna, Alessandra*; Paludetto, Roberto*; Pensabene, Licia; Greco, Luigi*; Campanozzi, Angelo; Borrelli, Osvaldo§; Romano, Claudio||; Chiaro, Andrea||; Guariso, Graziella; Staiano, Annamaria*

Journal of Pediatric Gastroenterology and Nutrition: March 2014 - Volume 58 - Issue 3 - p 307–312
doi: 10.1097/MPG.0000000000000209
Original Articles: Gastroenterology

Objective: This multicenter prospective study aimed to establish possible risk factors for functional constipation (FC) in the first year of life.

Methods: At the infant's age of 3, 6, and 12 months, parents of all included infants completed 2 questionnaires: one about the presence of FC and the other screened the possible risk factors for FC. Parents of 465 infants completed the questionnaires at 3 and 6 months and of 402 infants at 12 months of life.

Results: According to the Rome III criteria, FC was found in 11.6% of the infants at 3 months, in 13.7% at 6 months, and in 10.7% at 12 months after birth. Family history of atopy was present in 38.8% and 45.3% of infants with constipation at 3 and 6 months (P = 0.04 and P = 0.02, respectively), but no significant association was found at 12 months (P = 0.80). Breast-feeding was significantly related to a normal evacuation pattern at 3 months (P = 0.05), but not at 6 and 12 months (P = 0.12 and P = 0.9, respectively). Acetaminophen and female sex appeared to be risk factors for FC at 12 months. After the adjustment for all analyzed variables, FC in infants was significantly associated with the use of acetaminophen (odds ratio 6.98, 95% confidence interval 0.82–13.50).

Conclusions: Our results confirmed that breast-feeding is a protective factor for FC in the first 3 months of life and that the female sex is at risk to have FC. We found that the use of acetaminophen was associated with a higher incidence of FC in the first year of life.

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*Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II,” Naples

Department of Pediatrics, University Magna Graecia, Catanzaro

Department of Pediatrics, University of Foggia, Foggia, Italy

§Department of Pediatrics, Great Ormond Street Hospital, London, UK

||Department of Pediatrics, University of Messina, Messina

Department of Pediatrics, University of Padua, Padua, Italy.

Address correspondence and reprint requests to Annamaria Staiano, MD, Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II,” Via S. Pansini, 5, 80131 Naples, Italy (e-mail:

Received 9 October, 2013

Accepted 9 October, 2013

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The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,