Constipation in pregnancy: prevalence, symptoms, and risk factors.
OBJECTIVE
To prospectively estimate constipation prevalence and risk factors in pregnancy.


METHODS
We enrolled healthy pregnant women in this longitudinal study during the first trimester. At each trimester and 3 months postpartum, participants completed a self-administered bowel symptom questionnaire, physical activity and dietary fiber intake measures, and a prospective 7-day stool diary. Constipation was defined using the Rome II criteria (presence of at least two of the following symptoms for at least one quarter of defecations: straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, manual maneuvers to facilitate defecation, and fewer than three defecations per week). Generalized linear logistic models explored factors associated with constipation during pregnancy.


RESULTS
One hundred three women were enrolled with mean (+/-standard deviation) age of 28 (+/-5) years; 54% were nulliparous and 92% white. Constipation prevalence rates were 24% (95% confidence interval [CI] 16-33%), 26% (95% CI 17-38%), 16% (95% CI 8-26%), and 24% (95% CI 13-36%) in the first, second, and third trimesters and 3 months postpartum, respectively. Additionally, irritable bowel syndrome (by Rome II criteria) prevalence rates were 19% (95% CI 12-28%), 13% (95% CI 6-23%), 13% (95% CI 6-23%) and 5% (95% CI 1-13%) in the first, second, and third trimesters and 3 months postpartum, respectively. In multivariable longitudinal analysis, iron supplements (OR 3.5, 95% CI 1.04-12.10) and past constipation treatment (OR 3.58, 95% CI 1.50-8.57) were associated with constipation during pregnancy.


CONCLUSIONS
Constipation measured using the Rome II criteria affects up to one fourth of women throughout pregnancy and at 3 months postpartum.


METHODS
II.
Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA. catherine-bradley@uiowa.edu
Catherine S
CS
Bradley
Colleen M
CM
Kennedy
Anne M
AM
Turcea
Satish S C
SS
Rao
Ingrid E
IE
Nygaard
D000328:Adult; D003248:Constipation / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D007501:Iron / Q000009:adverse effects / Q000627:therapeutic use; D008137:Longitudinal Studies; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000473:pathology; D011264:Pregnancy Trimesters; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D007501:Iron