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Biopsychosocial factors associated with childhood urinary incontinence.

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eMediNexus    19 July 2018

A new study published in European Child & Adolescent Psychiatry examined the association between biopsychosocial factors and developmental trajectories of childhood urinary incontinence (UI). This study included 8,751 children, wherein developmental trajectories (latent classes) of childhood UI were analyzed from 4-9 years including bedwetting alone, daytime wetting alone, delayed (daytime and nighttime) bladder control, and persistent (day and night) wetting. The association of biopsychosocial factors – developmental level, gestational age, birth weight, parental UI, temperament, behavior/emotional problems, stressful events, maternal depression, age at initiation of toilet training, constipation, with the trajectories were examined. It was found that maternal history of bedwetting was associated with almost a fourfold increase in odds of persistent wetting. In a majority of the cases, difficult temperament and behavior/emotional problems were most strongly associated with combined (day and night) wetting, for instance, children with behavioral difficulties had increased odds of delayed (daytime and nighttime) bladder control. Meanwhile, maternal postnatal depression was associated with persistent (day and night) wetting and daytime wetting alone. Besides bedwetting, developmental delay, stressful events, and later initiation of toilet training were associated with the other UI trajectories. Contrastingly, constipation was only associated with delayed bladder control. Thus, the results suggested that different trajectories of childhood UI are differentially associated with biopsychosocial factors. It was stated that an increased understanding of factors associated with different trajectories of childhood UI could help clinicians in identifying children at risk of persistent incontinence.

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