Gastrointestinal consequences of cesarean section birth: A systematic review of short- and long-term effects in infancy and beyond

Table 2 Summary of short-term functional gastrointestinal disorder risk in cesarean section vs vaginally delivered infants

Ref.	Sample size	FGID evaluated	C-section association	Statistical significance	Risk of bias
Salvatore et al[11], 2019	934	Colic, regurgitation, dyschezia, constipation	↑ Colic (RR: 1.23), ↑ dyschezia (RR: 1.20), ↑ any FGID (RR: 1.14)	Significant (P < 0.01 for all)	Low (well-powered, defined FGIDs, adjusted)
Bi et al[12], 2023	988 (preterm)	Colic, regurgitation, dyschezia, constipation	73.4% had ≥ 1 FGID; C-section strongly associated	Significant (P < 0.001)	Moderate (preterm bias, but strong stats)
Pantazi et al[13], 2025	134	FGID + gut microbiota profile	C-section → ↑ dysbiosis, ↓ Bifidobacterium, ↑ E. coli	Significant (P < 0.05 for key microbes)	Moderate (small sample, integrated analysis)
Ziętek et al[14], 2024	82	Colic, regurgitation, constipation	↑ Regurgitation in C-section-born at 3-6 months	Significant (P = 0.0434)	High (small cohort, limited follow-up)
Bekem et al[15], 2021	213	Dyschezia, regurgitation	↑ Dyschezia (C-section: 83.3%), ↑ regurgitation (C-section: 88.9%)	Significant (P = 0.006 and 0.035)	Moderate (retrospective design)
Velasco-Benitez et al[16], 2020	1497	School-age FGIDs (longitudinal)	No significant C-section association in older children	Non-significant (P > 0.05)	Low (large cohort, age-stratified, well-controlled)

P value less than 0.05 is considered significant. C-section: Cesarean section; FGID: Functional gastrointestinal disorder; RR: Relative Risk; E. coli: Escherichia coli.