Constipation in very-low-birth-weight children at 10 to 14 years of age

Background: The authors documented that very-low-birthweight children (less than 750-g) when compared with 750- to 1,499-g birth-weight and normal-bir th-weight-matched controls have higher than normal rates of neurosensory an d cognitive impairments at school age. In this population, the authors foun d a higher rate of constipation than expected among 19 of 59 (32%) less-tha n-750-g-birth- weight children. The authors therefore wanted to evaluate in greater detail the problem of constipation and associated toileting proble ms in this population. Methods: Nineteen less-than-750-g-birth-weight children with constipation w ere matched to the next less than 750-g-birthweight child of comparable age , sex, and race who did not have constipation. A telephone questionnaire wa s administered to 15 of 19 parents of the less-than-750-g-birth-weight chil dren who had constipation. Results: The 15 children with constipation had significantly higher rates o f neurosensory impairment (7 [47%] vs. 1 [7%]) and lower mean WISC III IQ s cores (72 +/- 22 vs. 89 +/- 13) when compared with birth-weight-matched con trols without constipation (P < 0.05). The constipated children also had si gnificantly higher rates of associated toileting problems, including encopr esis (8[53%] vs. 1 [7%])and stool withholding (9 [60%] vs. 2 [13%]; P < 0.0 5). Conclusion: The higher incidence of constipation among less-than- 750-g-bir th-weight children is associated with neurodevelopment impairment. Awarenes s of this problem and preventive intervention to ensure regular stools coul d possibly decrease the high rate of constipation and associated toileting problems.