Prevalence and influencing factors of functional constipation in Chinese children and adolescents: a systematic review and meta-analysis

Objective In recent years, the incidence of functional constipation in children and adolescents has been increasing annually, seriously affecting their physical and mental development and quality of life, and placing a significant burden on society and families. This study aims to conduct a systematic review and meta-analysis to explore the prevalence and influencing factors of functional constipation among children and adolescents in China, providing evidence-based evidence for developing scientific intervention strategies for patients with functional constipation. Methods We systematically searched relevant studies in databases including CNKI, Wanfang Data Knowledge Service Platform, SinoMed, VIP, PubMed, EmBase, Web of Science, and Cochrane Library from their inception until December 28, 2025. Two researchers independently screened and cross-checked the studies. The quality of cross-sectional studies was assessed using the evaluation tool from the Agency for Healthcare Research and Quality (AHRQ), and meta-analysis was conducted using Stata 17.0 software. Results We finally included 27 studies, involving a total of 112,801 cases. The results showed that the prevalence of functional constipation among children and adolescents in China was 7.8% (95% CI (6.0, 9.9%)). Subgroup analysis demonstrated that children and adolescents aged 5–12 years, females, those residing in North China, those diagnosed according to the Rome IV criteria, and those studied from 2021 onwards had a higher prevalence of functional constipation. Risk factors for functional constipation included female, family history of constipation, inadequate water intake, low intake of vegetables and fruits, low physical activity, being scolded for poor bowel habits in early childhood, non-breastfeeding, picky eating, food allergy, obesity, and high household income. Protective factors included adequate sleep and the development of good bowel habits. Conclusion Current evidence indicates a relatively high prevalence of functional constipation among children and adolescents in China and is impacted by diverse factors. Therefore, future initiatives should prioritize training for primary healthcare professionals, conducting health education campaigns, raising parents’ awareness of the risks associated with functional constipation in children and adolescents, reducing the prevalence of the condition, and improving the quality of life for affected children and their families.