Pregnancy, puerperium and perinatal constipation – an observational hybrid survey on pregnant and postpartum women and their age‐matched non‐pregnant controls

Abstract

Objective To evaluate the prevalence of constipation during pregnancy and early puerperium. Design Observational survey. Setting Secondary and tertiary hospital in Finland. Population Pregnant (n = 474) and postpartum (n = 403) women and a control group of 200 non‐pregnant women who did not give birth in the past year. Methods Women reported bowel function and other gastrointestinal symptoms on a structured questionnaire using an 11‐point numerical rating scale (0 = no symptom, 10 = most severe symptom) and binominal yes/no questions during the second and third trimesters and few days and 1 month after childbirth. Main outcome measure Prevalence of constipation based on the Rome IV criteria. Results The data consist of five cohorts of women: second trimester (n = 264), third trimester (n = 210), after vaginal delivery (n = 200) or caesarean section (n = 203), and a control group (n = 200). The prevalence of constipation was 40% in pregnant women and 52% (P < 0.001) in postpartum women, which was a higher prevalence than that in the control group, where 21% had constipation (P < 0.001). A few days after delivery, the prevalence of constipation was lower after vaginal delivery (47%) than caesarean section (57%, P < 0.039). One month postpartum, the prevalence of constipation was low: 9% after vaginal delivery (P = 0.002 compared with the control group) and 15% after caesarean section. Other gastrointestinal symptoms were common; pregnant women had the highest prevalence (34%) of nausea/vomiting. Conclusion The prevalence of constipation was two‐ to three‐fold higher in pregnant women and a few days after delivery than in non‐pregnant women. During puerperium, bowel function returned to or below that reported in non‐pregnant women. Tweetable abstract Constipation is common in pregnancy and after delivery, but bowel function returns early in puerperium.

Constipation, Hemorrhoids, and Anorectal Disorders in Pregnancy

“…When prevalence was assessed based on survey respondent self-reporting, 61% reported constipation in the second trimester, 55% in the third trimester, and 77% and 88% a few days after vaginal or caesarean deliveries, respectively. By 1 month postpartum, constipation was self-reported in approximately 30% for both delivery types, which was similar to the self-reported incidence of 37% in the control group (9).…”

“…Despite this high frequency, constipation during and after pregnancy is often neglected (8). A recent survey study involving 1,078 participants from Finland used modified Rome IV criteria (symptoms with 25% of defecations over 3 months) and reported a prevalence of constipation in 40% of pregnant and 52% of postpartum women, compared with only 21% in nonpregnant and similarly aged controls (9). Rates were not significantly different between the second and third trimesters.…”

Nursing Diagnoses and Interventions in Women with Hypertensive Disorders of Pregnancy: A Scoping Review

“…The constipation diagnosis was found in three studies included in this review. Constipation is related to bad eating habits, such as low fiber and water intake, and a low or nonexistent relationship with physical activity (34). In turn, a research study (35) showed that a sedentary lifestyle and a Body Mass Index greater than 24 influence intestinal transit, leading to constipation in pregnancy.…”

Clinical advances: pregnancy in gastroenterologic and hepatic conditions

“…Other conditions that are common are anal fissure in the second trimester (10.6%), haemorrhoidal prolapse in the third trimester (14.4%), haemorrhoidal thrombosis immediately post partum (14.6%) and postpartum anal fissure at 3 months (9.6%) 13. A recent survey study involving 1078 Finnish women using modified Rome IV criteria (symptoms with 25% of defecations over 3 months) reported a prevalence of constipation in 40% of pregnant and 52% of postpartum women, compared with only 21% in non-pregnant and similarly aged controls 14. Rates were not significantly different between the second and third trimesters.…”