High Concurrence of Nocturnal Enuresis and Associated Factors among South Chinese Children

Abstract

Background: Nocturnal enuresis (NE) is not an uncommon disease in children, and the prevalence and clinical features have regional variations, but the relative data is scanty in southern China. The aim of this study is to establish the prevalence of NE and predictive factors in a large population of South Chinese children. Methods: From December 2013 to July 2014, 15547 questionnaires were distributed to parents and children of 14 primary schools in Guangzhou and Zhongshan. Results: Correctly completed response rate was 74.6%. Overall NE prevalence was 10.9% (1260/11599). NE was significantly more frequent in boys (P<0.001). Prevalence decreased progressively from 6−7 years (13.6%) to 12−14 years (7.6%). Most children with NE wetted after midnight (63.3%), and fewer than once per week (76.6%). Nearly 16.4% of children with NE suffered from constipation. Children with NE stopped using diapers at older ages than children without NE (P<0.001), and 6.6% were still using diapers. Sleep-disordered breathing (SDB) was reported in 36.9% of cases; main symptoms were mouth breathing (38.5%), snoring (34.3%), and restlessness (30.5%). Family history was present in 22.5% and urinary system disease history in 9.4% of cases. Only 20.5% had received treatment, 0.9% with enuresis alarms and 5.4% with drugs. Parental self-help strategies included fluid restriction (25.2%) and voiding (85.9%) before bed, while 36.9% lacked awareness of NE. Conclusions: The occurrence of NE was still high among primary school in south China. The possible factors include over-using diapers, positive family history, complicated with SDB, constipation, male gender and younger age.