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Incontinence in persons with fetal alcohol spectrum disorders: a polish cohort
Sylvia Roozen1, Katarzyna Anna Dylag2, Katarzyna Przybyszewska3
1Governor Kremers Centre, Maastricht University Medical Centre+, the Netherlands; Department of Work and Social Psychology, Maastricht University, the Netherlands.
Insights
Fetal alcohol spectrum disorders (FASD) are linked to incontinence, affecting 24% of individuals. Specific types of incontinence, like nocturnal enuresis and fecal incontinence, were more prevalent in certain FASD diagnoses, highlighting a significant public health concern.
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Public Health
Background:
- Fetal alcohol spectrum disorders (FASD) are a significant, preventable public health issue.
- Incontinence is a common pediatric problem associated with FASD, yet its prevalence and presentation remain poorly understood.
- This knowledge gap hinders effective management strategies for individuals with FASD.
Purpose of the Study:
- To investigate the prevalence and presentation of incontinence in individuals diagnosed with FASD.
- To compare incontinence rates in FASD populations with control groups.
Main Methods:
- Parental questionnaires were administered to participants with FASD.
- Two clinical control groups were established: patients receiving immunotherapy for pollen allergy (GKA) and patients diagnosed with celiac disease (GKG).
- A total of 119 participants were included: FAS (n=24), partial FAS (pFAS) (n=19), alcohol-related neurodevelopmental disorder (ARND) (n=28), GKA (n=34), and GKG (n=14).
Main Results:
- Overall incontinence prevalence in the FASD group was estimated at 24% (CI 15-36%).
- Specific types of incontinence included nocturnal enuresis (NE) in 10% (CI 4-19%), daytime urinary incontinence (DUI) in 11% (CI 5-21%), and fecal incontinence (FI) in 13% (CI 6-23%).
- Urgency symptoms were reported by 52% of participants, voiding postponement by 10%, and straining by 2%.
Conclusions:
- Incontinence affects children and adolescents across various FASD diagnoses (FAS, pFAS, ARND) and control groups.
- Highest rates of incontinence were observed in partial FAS (pFAS) and alcohol-related neurodevelopmental disorder (ARND).
- Specific incontinence types varied by diagnosis: DUI in FAS, NE in pFAS, and FI in ARND.
Introduction:
Fetal alcohol spectrum disorders (FASD) is an important preventable public health concern, associated to a number of common pediatric problems such as incontinence. Little is known about the prevalence and presentation of incontinence in FASD, which hinders effective management.
Objective:
The aim of the present study was to investigate incontinence among people with FASD.
Study Design:
Parental questionnaires were sent to all eligible FASD participants. To enable comparing the observed prevalence with typically developing, non-prenatally alcohol-exposed individuals, two clinical control groups of patients undergoing immunotherapy for pollen allergy (GKA) and patients diagnosed with celiac disease (GKG) were selected.
Results:
A total of 119 participants were included in the study (FAS: n = 24, partial fetal alcohol syndrome [pFAS]: n = 19, alcohol-related neurodevelopmental disorder [ARND]: n = 28, GKA: n = 34, and GKG: n = 14). Overall incontinence for FASD was estimated to be 24% (confidence interval [CI] ranges from 15 to 36); nocturnal enuresis (NE) was present in 10% (CI ranges from 4 to 19), daytime urinary incontinence (DUI) in 11% (CI ranges from 5 to 21), and fecal incontinence (FI) in 13% (CI ranges from 6 to 23). Symptoms of urgency were present for 52%, voiding postponement for 10%, and straining for 2%. These data are both consistent with higher prevalence in individuals with FASD and with similar prevalence (the CIs overlap).
Conclusion:
Children and adolescents with FAS, pFAS, ARND, GKA, and GKG are affected by incontinence. Highest rates were observed in pFAS and ARND. Persons with FAS were mostly affected by DUI, those with pFAS by NE, and those with ARND by FI.
