Bladder and bowel continence in bilateral cerebral palsy: A population study

Area of Science:

• Pediatrics
• Developmental Pediatrics
• Neurology

Background:

• Continence is a key developmental milestone for all children.
• Children with disabilities, including bilateral cerebral palsy (BCP), may face unique challenges in achieving continence.

Purpose of the Study:

• To determine the age of bladder and bowel continence in children with BCP.
• To investigate the association between continence and intellectual impairment (II) and motor disability severity (GMFCS).

Main Methods:

• A population-based prospective study interviewed parents of 346 children with BCP at ages 3, 7, and 17.
• Continence data (day and night) were collected and compared to controls from the Avon Longitudinal Study of Parents and Children (ALSPAC).

Main Results:

• BCP children achieved daytime bladder and bowel continence at a median age of 5.4 years, compared to 2.4 years for controls.
• At 17 years, 60.8% of BCP children were continent by day and 54.6% by night, versus nearly all controls.
• Motor disability severity (GMFCS) and intellectual impairment (II) were significantly associated with continence attainment (P < 0.0001).

Conclusions:

• Children with BCP experience delayed and less complete bladder and bowel continence compared to controls.
• Motor disability and intellectual impairment significantly impact continence, affecting motivation, understanding, communication, and independence.
• Shared expectations with parents and active investigation of continence issues are crucial for children with BCP.