Pediatr Gastroenterol Hepatol Nutr.  2020 Jul;23(4):366-376. 10.5223/pghn.2020.23.4.366.

Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants

  • 1Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
  • 2Unit of Pediatrics and Neonatology, “F. Del Ponte” Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
  • 3Department of Medical and Surgical Sciences, Pediatric Unit, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
  • 4Pediatric Unit, Saronno Hospital, Saronno, Italy
  • 5Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy


To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life.
This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10–90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life.
Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic.
We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.


Fetal development; Birth weight; Infant, small for gestational age; Large for gestational age; Infantile colic; Infant, extremely low birth weight; Functional gastrointestinal disorders
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