When interviewed and evaluated at age 10 years of age, 19/58 (33%) parents of ELBW children (mean bwt 664 gm, mean gest age 26 wks) born 1982-1986, reported constipation to be a problem compared to 6/53 (11%) of children with birthweight 750-1499 gm and 3/49 (6%) normal birthweight controls (p<.001). Constipation was defined as difficulty in passing, hard, dry stools. To determine the etiology we compared neonatal and neurodevelopmental outcomes of the constipated to non-constipated ELBW children. Group differences are summarized below. Thus constipated ELBW were of lower gestational age at birth, had more neonatal problems including NEC, and had higher rates of neurologic abnormality (4 cerebral palsy, 1 blind, 1 deaf) and subnormal IQ than non-constipated ELBW. Further history obtained from 15 of 19 parents of the constipated ELBW at age 12 years revealed that for 13 of the 15 children constipation began prior to age 6 months. Four children were severely retarded and not toilet trained and 8 of the remaining 11 were still having soiling accidents. Among 15 non-constipated ELBW matched by race and sex, only 1 was not toilet trained and 4 were still having soiling accidents at age 12 years. Table

Table 1 No caption available.
Full size table

The constipation among ELBW is probably associated with neurodevelopmental impairment but could also be secondary to neonatal ischemic injury.

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