A prospective cohort study of biopsychosocial factors associated with childhood urinary incontinence

Carol Joinson*, Mariusz Tadeusz Grzeda, Alexander von Gontard, Jon Heron

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

3 Citations (Scopus)
215 Downloads (Pure)

Abstract

The objective of the study was to examine the association between biopsychosocial factors and developmental trajectories of childhood urinary incontinence (UI). We used developmental trajectories (latent classes) of childhood UI from 4–9 years including bedwetting alone, daytime wetting alone, delayed (daytime and nighttime) bladder control, and persistent (day and night) wetting (n = 8751, 4507 boys, 4244 girls). We examined whether biopsychosocial factors (developmental level, gestational age, birth weight, parental UI, temperament, behaviour/emotional problems, stressful events, maternal depression, age at initiation of toilet training, constipation) are associated with the trajectories using multinomial logistic regression (reference category = normative development of bladder control). Maternal history of bedwetting was associated with almost a fourfold increase in odds of persistent wetting [odds ratio and 95% confidence interval: 3.60 (1.75–7.40)]. In general, difficult temperament and behaviour/emotional problems were most strongly associated with combined (day and night) wetting, e.g. children with behavioural difficulties had increased odds of delayed (daytime and nighttime) bladder control [1.80 (1.59–2.03)]. Maternal postnatal depression was associated with persistent (day and night) wetting [2.09 (1.48–2.95)] and daytime wetting alone [2.38 (1.46–3.88)]. Developmental delay, stressful events, and later initiation of toilet training were not associated with bedwetting alone, but were associated with the other UI trajectories. Constipation was only associated with delayed bladder control. We find evidence that different trajectories of childhood UI are differentially associated with biopsychosocial factors. Increased understanding of factors associated with different trajectories of childhood UI could help clinicians to identify children at risk of persistent incontinence.

Original languageEnglish
Number of pages8
JournalEuropean Child and Adolescent Psychiatry
Early online date6 Jul 2018
DOIs
Publication statusE-pub ahead of print - 6 Jul 2018

Keywords

  • ALSPAC
  • Bedwetting
  • Child urinary incontinence
  • Daytime wetting
  • Developmental trajectory
  • Prospective cohort

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