Early childhood risk factors for constipation and soiling at school age: an observational cohort study.

Heron, J., Grzeda, M., Tappin, D. , von Gontard, A. and Joinson, C. (2018) Early childhood risk factors for constipation and soiling at school age: an observational cohort study. BMJ Paediatrics Open, 2(1), e000230. (doi: 10.1136/bmjpo-2017-000230) (PMID:29637194) (PMCID:PMC5843013)

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Objective: Constipation and soiling are common in childhood. This study examines the comorbidity between childhood constipation and soiling and early childhood risk factors for these problems. Design: The sample comprised 8435 participants from the Avon Longitudinal Study of Parents and Children with maternally reported measures of constipation (six time points between 4 and 10 years) and soiling (five time points between 4 and 9 years). We used latent class analysis to extract longitudinal patterns of constipation and soiling. We examined whether the latent classes are differentially associated with maternally reported risk factors in early childhood (stool consistency, breast feeding, socioeconomic background, gestation, birth weight, developmental level and age at initiation of toilet training) using multinomial logistic regression models. Results: We extracted four latent classes: ‘normative’ (74.5%: very low probability of constipation or soiling), ‘constipation alone’ (13.2%), ‘soiling alone’ (7.5%) and ‘constipation with soiling’ (4.8%). Hard stools at 2½ years were associated with increased odds of constipation alone. Developmental delay at 18 months was associated soiling alone and constipation with soiling, but not constipation alone. We found limited evidence of associations with socioeconomic background and no evidence of associations with age at initiation of toilet training, breast feeding, gestational age or birth weight. Conclusion: Constipation alone was the most prevalent pattern in this cohort. Treatment for hard stools in early childhood is needed to prevent chronic constipation at school age. Constipation with soiling was less common than soiling alone. Further research is needed into the causes of non-retentive soiling.

Item Type:Articles
Keywords:ALSPAC, gastroenterology.
Glasgow Author(s) Enlighten ID:Tappin, Professor David
Authors: Heron, J., Grzeda, M., Tappin, D., von Gontard, A., and Joinson, C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMJ Paediatrics Open
Publisher:BMJ Publishing Group
ISSN (Online):2399-9772
Published Online:21 February 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in BMJ Paediatrics Open 2(1):e000230
Publisher Policy:Reproduced under a Creative Commons License

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