The association between trajectories of bedwetting and daytime wetting in childhood and incontinence and lower urinary tract symptoms in adolescence.

Carol Joinson, Mariusz Tadeusz Grzeda, Alexander von Gontard, Anne Wright, Jon E Heron

Research output: Chapter in Book/Report/Conference proceedingConference Contribution (Conference Proceeding)

Abstract

Aims: This is the first prospective cohort study to examine the association between developmental trajectories of childhood incontinence and adolescent incontinence and lower urinary tract symptoms (LUTS).
Methods: We used longitudinal latent class analysis to identify developmental trajectories of bladder control using maternal reports of their child's incontinence from 4–9 years in 8,751 participants from the Avon Longitudinal Study of Parents and Children. We then used logistic regression to examine the association between the trajectories and self-reported bedwetting, daytime wetting, nocturia, urgency, high voiding frequency and voiding postponement at 14 years.
Results: We identified five trajectories: (i) Normative development of daytime and nighttime bladder control (63.1% of the sample), (ii) Delayed attainment of bladder control (8.6%), (iii) Bedwetting alone (no daytime wetting) (15.6%), (iv) Daytime wetting alone (no bedwetting) (5.8%), (v) Persistent wetting (bedwetting with daytime wetting to age 9) (7.0%). There were increased odds of bedwetting at 14 years among those with persistent wetting in childhood (odds ratio=23.5, 95% confidence interval=15.1–36.4) and bedwetting alone (3.69 [2.21–6.17]) (reference category: normative development). Odds of daytime wetting at 14 years were increased among those with daytime wetting alone (odds ratio=10.1 [6.70–15.3]) and persistent wetting (6.98 [4.50–10.8]). There were increased odds of nocturia (2.39 [1.79–3.20]) and urgency (2.10 [1.44–3.07]) in those with persistent wetting and increased odds of voiding postponement (1.94 [1.48–2.54]) in those with daytime wetting alone.
Conclusions: We find evidence that trajectories of incontinence in childhood are differentially associated with adolescent incontinence. Bedwetting in adolescence was more likely in those who experienced persistent wetting in childhood compared with bedwetting alone. Daytime wetting in adolescence was associated with childhood daytime wetting and persistent wetting. LUTS were more common among adolescents who experienced childhood incontinence than those who had normal bladder development. The awareness of particular patterns of incontinence is important in clinical practice because children exhibiting incontinence trajectories associated with poor outcomes in adolescence should be prioritised for investigations and treatment.
Original languageEnglish
Title of host publicationArchives of Disease in Childhood
Subtitle of host publicationRoyal College of Paediatrics and Child Health. Abstracts of the Annual Conference
Place of PublicationUK
PublisherBMJ Publishing Group
PagesA187
Number of pages1
Volume101
Edition1
ISBN (Electronic)1468-2044
ISBN (Print)0003-9888
Publication statusPublished - Apr 2016
EventRoyal College of Paediatrics and Child Health Annual Conference - ACC, Liverpool, United Kingdom
Duration: 26 Apr 201628 Apr 2016

Conference

ConferenceRoyal College of Paediatrics and Child Health Annual Conference
CountryUnited Kingdom
CityLiverpool
Period26/04/1628/04/16

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