Prevalence and risk factors of nocturnal enuresis among children ages 5–12 years in Xi’an, China: a cross-sectional study

Abstract

Background: Nocturnal enuresis (NE) has a negative impact on children's health and imposes a long-term burden on families. With economic development and cultural improvements, parents and medical professionals pay more attention to NE. The aim of this study was to investigate the prevalence and risk factors of NE among children ages 5-12 years in Xi'an, China. Methods: A stratified cluster sampling method was used to conduct a cross-sectional study of NE in 10 kindergartens and 20 primary schools in Xi'an. We used univariate analysis to compare the prevalences of characteristics such as gender, duration of disposable diaper (DD) use, toilet training onset time, daily living habits, academic performance, and family history of NE. Logistic regression analysis was used to calculate odds ratio and to determine risk factors of NE. Results: The study included 6568 children ages 5-12 years, of which 262 (3.99%) had NE. The prevalence rates of NE decreased with age, with the highest prevalence at age 5 (9.09% for boys; 6.03% for girls). However, the prevalence increased with duration of DD use. Children experienced more NE if they never accepted toilet training (7.83%) or if they drank sugary beverages during the day (5.36%). Sleep disorders, sweets intake, drinking low amounts of plain water during the day, and family history of NE, were statistically associated with NE. Conclusion: NE was closely associated with a family history of NE, being male, long-term use of DD, delayed toilet training, drinking sugary beverages and/or consuming little plain water, and sleep disorders. A supportive parental attitude towards NE and timely medical treatment can improve the quality of life of enuretic children.

Decreased vitamin D levels in children with primary mono-symptomatic nocturnal enuresis

“…Several studies have shown that the NE level decreases as age increases [12]. According to Alhifthy et al [13] the prevalence of NE was 63% at the age of 6-7 years and 4.5% at the age of 10-12 years old that is consistent with previous reports [5,14].…”

Evaluation of Factors Affecting Enuresis in 6- to 12-Year-Old Children Referred to the Pediatric Nephrology Clinic

“…3 In children with enuresis in our study, enuresis incidence in boys was higher than in girls, which is concordant with other studies. 18,19 However, there was no significant difference between boys and girls.…”

“…In a study by Huang et al, parental education was not found to be significantly associated with enuresis. 18 In contrast, Hamed et al found that the education level of both mother and father has a significant association with enuresis. 22 In our study, only the father's education was significantly higher in children with enuresis.…”

Does the development and use of modern disposable diapers affect bladder control? A systematic review

“…Patients suffering from enuresis experience reduced quality of life compared with healthy children [36,37]. In literature, several independent researchers have reported a rise in prevalence of enuresis [4,28,29,38,39] over the last 30 years.…”

“…The treatment consists of behavioural interventions, alarm-treatment, desmopressin [2], anticholinergic medication or a combination. The age of initiating toilet training (TT) is increasing in western countries [3], and so is the reported prevalence of enuresis in areas that only recently adapted the use of modern disposable diapers (DD) such as China [4,5]. Although hypothesized currently no evidence suggests, that the use of DD postpones the time of bladder control attainment, or that removal of the DD leads to resolution of enuresis.…”