Retarded skeletal maturation in children with primary enuresis

Primary nocturnal enuresis (PNE) is a common paediatric problem of multifactorial aetiology. Growth and skeletal maturation were studied in 35 otherwise healthy children with PNE, 26 boys and 9 girls aged 6-14 years, and comparison was made with a control (CTR) group of 19 boys and 3 girls aged 6-13 years of similar ethnic origin. There was no significant difference between the mean height and weight centiles of the two groups. Bone age (BA) determined by the TW-2 method showed a significant lag behind chronological age (CA); the CA-BA difference being 1.46 +/- 1.56 years in the PNE group and -0.08 +/- 0.8 years in the CTR group (P less than 0.001). In 11 of the PNE group (31%) the BA retardation was greater than 24 months: in 4 it was between 24 to 36 months and in 7 the difference was greater than 36 months. In all these children T4 and TSH were found to be normal. It is hypothesised that the retarded bone age in children with PNE may reflect delayed maturation of regulatory CNS functions.