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Bed-wetting in US children: epidemiology and related behavior problems
R S Byrd1, M Weitzman, N E Lanphear
1Department of Pediatrics, University of Rochester School of Medicine and Dentistry, New York, USA.
Insights
Bed-wetting in children is linked to behavior problems, even infrequent cases. Healthcare providers should assess behavioral issues when bed-wetting is present.
Area of Science:
- Pediatric Health
- Behavioral Science
- Epidemiology
Background:
- Bed-wetting (nocturnal enuresis) is common in childhood.
- Understanding its association with behavioral issues is crucial for comprehensive care.
Purpose of the Study:
- To investigate the epidemiology of bed-wetting in children.
- To explore the behavioral correlates of bed-wetting in a national sample.
Main Methods:
- Analysis of cross-sectional data from 10,960 children aged 5-17 years.
- Utilized the Child Health Supplement to the National Health Interview Survey.
- Behavior problems assessed using the Behavior Problem Index (BPI).
Main Results:
- Bed-wetting prevalence decreased with age, from 33% at age 5 to 0.7% at age 17.
- Lower age, male gender, and high BPI scores were associated with bed-wetting.
- Children with bed-wetting had higher rates of behavior problems, regardless of frequency.
Conclusions:
- Bed-wetting in children aged 5+ is associated with increased behavior problems.
- Healthcare providers should explore behavioral issues in children with bed-wetting, even if infrequent.
Objective:
To better understand the epidemiology and behavioral correlates of bed-wetting in a nationally representative sample of children.
Methods:
Bivariate and multivariate logistic regression analyses of cross-sectional data regarding 10 960 children aged 5 through 17 years from the 1981 Child Health Supplement to the National Health Interview Survey. Behavior problems were determined by extreme scores on a 32-item Behavior Problem Index (BPI, > 90th percentile).
Results:
Bed-wetting was reported in 33% of 5-, 18% of 8-, 7% of 11-, and 0.7% of 17-years-olds. At all ages, infrequent bed-wetting (fewer than six episodes per year) accounted for half of all reported bed-wetting. Lower age, male gender, and extreme scores on the BPI all were independently associated with both infrequent and frequent bed-wetting. Extreme scores on the BPI were more common among children with bed-wetting than those who did not wet the bed, and the risk for this was similar among children with infrequent and frequent bed-wetting (adjusted odds ratios, 1.8 and 1.7, respectively). Parents' perceived need for help with emotional and behavioral problems, however, was increased only among children with frequent bed-wetting.
Conclusions:
Bed-wetting in children aged 5 years and older, irrespective of its frequency, is associated with increased rates of behavior problems. Thus, although infrequent bed-wetting may not warrant medical intervention, this condition should prompt health care providers to explore behavioral issues in greater depth.