Summary
Introduction
Nocturnal enuresis (NE) is a common elimination problem that affects physical and
psychological health of children older than 5 years, and more than 80% of them are
primary. Frequent nocturnal enuresis (FNE) usually refers to involuntary urination
more than 4 times a week during sleep. Children who frequently wet the bed are more
likely to become adults with NE. The arousal dysfunction in response to micturition
desire is the main pathogenesis of NE. Epilepsy is a common neurological disorder,
which essentially reflects various diseases of brain dysfunction. Previous studies
had suggested a possible association between epilepsy and NE.
Objectives
To examine the association between epilepsy and FNE and to investigate the related
risk factors of FNE.
Study design
This was an in-depth analysis of a population-based cross-sectional study in Shanghai,
China. There were 74 252 children aged 3–12 years old recruited using the multi-stage
stratified cluster random sampling method. After ruling out 11 962 (16.1%) children
aged less than 5 years, a total of 62 290 children were included in the study. They
were surveyed for the demographic characteristics via questionnaires. In this study,
IBM SPSS Statistics Version 23 was used for data analysis. Chi-square, t-test, univariable
and multivariable logistic regression models were used.
Results
The epilepsy rate was significantly higher in children with FNE (2.1%) than that in
children without (0.3%). After adjusting for confounding factors (sex, gestational
age, birth weight, maternal age, academic performance, parent’ education level, annual
household income and autism spectrum disorder) in multivariable models, the incidence
of epilepsy in children with FNE was 6.254 times higher than that in children without.
Moreover, the adjusted OR was higher in girls than that in boys. Regarding age, the
association between epilepsy and FNE existed exclusively among children aged 9–12
years.
Discussion
In the study, epilepsy was significantly associated with FNE, girls and preadolescent
children were at higher risk. Puberty begins earlier in girls than in boys. Increased
secretion of hormones might affect susceptibility to both epilepsy and FNE. It is
hypothesized that persistent brain injury caused by multiple seizures may lead to
progression to FNE in patients with NE. However, this was a preliminary investigation.
The potential to diagnosis previously unrecognized epilepsy among children with FNE
was not addressed by this study.
Conclusion
Summary TableMultivariable logistic regression models to analyse the association of Epilepsy with
FNE, and the association of Epilepsy with FNE in different genders and age groups.
| Adjusted OR | 95% CI | P Value | |
|---|---|---|---|
| Epilepsy | 6.254 | 2.612–14.973 | ＜0.001 |
| Age | |||
| 5–6 years old | 6.915 | 0.882–54.210 | 0.066 |
| 7–8 years old | 0.000 | 0.000 | 0.998 |
| 9–12 years old | 9.877 | 3.609–27.027 | ＜0.001 |
| Gender | |||
| Girl | 9.900 | 2.839–34.521 | ＜0.001 |
| boy | 4.917 | 1.438–16.811 | 0.011 |
OR: odds ratios, CI: confidence intervals.
∗ The confounding factors included autism spectrum disorder, gestational age, birth
weight, maternal age, academic performance, parents’ education level, annual household
income and sex.
Keywords
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Article info
Publication history
Published online: October 05, 2022
Accepted:
September 24,
2022
Received in revised form:
August 29,
2022
Received:
May 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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