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Early Behavioral Risks of Childhood and Adolescent Daytime Urinary Incontinence and Nocturnal Enuresis

Vasconcelos, Monica M. A. MD, PhD*; East, Patricia PhD; Blanco, Estela MPH; Lukacz, Emily S. MD, MAS; Caballero, Gabriela BS§; Lozoff, Betsy MD; Gahagan, Sheila MPH, MD

Journal of Developmental & Behavioral Pediatrics: November/December 2017 - Volume 38 - Issue 9 - p 736–742
doi: 10.1097/DBP.0000000000000516
Original Articles

Objective: To investigate whether infant temperament and childhood internalizing, externalizing, and inattention symptoms increase the likelihood of daytime urinary incontinence or nocturnal enuresis at 10 years and adolescence (11.9–17.8 years).

Method: Data were from a longitudinal cohort of 1119 healthy Chilean children. We assessed behavioral symptoms at infancy, 5 years, and 10 years and their relationship with subsequent daytime urinary incontinence and nocturnal enuresis.

Results: Daytime urinary incontinence and nocturnal enuresis occurred in, respectively, 3.3% and 11.4% at 10 years and 1.1% and 2.7% at adolescence. Difficult infant temperament was associated with increased odds of 10-year daytime urinary incontinence. Inattention at 5 years was associated with increased odds for nocturnal enuresis at 10 years and adolescence. Internalizing and externalizing symptoms at 5 years were associated with increased odds of 10-year daytime urinary incontinence and nocturnal enuresis. Internalizing and externalizing symptoms at 10 years were associated with adolescent nocturnal enuresis.

Conclusion: Temperament and internal/externalizing symptoms may be risk factors for school-age and adolescent urinary incontinence.

*Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;

Department of Pediatrics, University of California, San Diego, La Jolla, CA;

Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA;

§Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile;

Center for Human Growth, University of Michigan, Ann Arbor, MI.

Address for reprints: Patricia East, PhD, Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0927; e-mail: peast@ucsd.edu.

Supported by the National Institutes of Health, the Heart, Lung, and Blood Institute (R01-HL-088530, PI: S.G.) and the National Institute of Child Health and Human Development (R01-HD33487, PIs: B.L. and S.G.). M. M. A. Vasconcelos was supported by Coordenaçao de Apoio ao Pessoal de Ensino Superior, which supports Brazilian faculty as visiting scholars abroad (CAPES 2769/15-8).

Disclosure: The authors declare no conflict of interest.

The research study described in this manuscript was conducted with human subjects, and all study procedures were reviewed and approved by the relevant university institutional review boards. All study procedures were performed in accordance with The Code of Ethics of the World Medical Association. Informed written consent was obtained from all adult individual participants, and informed assent was obtained from child participants. This study did not involve animals.

Received April , 2017

Accepted June , 2017

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