Ten kindergartens and 20 primary schools were selected by stratified cluster sampling. Thus, we sought to investigate the prevalence of NE in children ages 5–12 years in Xi’an and assess potential risk factors of NE, to provide baseline data for prevention and treatment.įrom December 2018 to January 2019, we conducted a cross-sectional survey of NE among children ages 5–12 years in five regions throughout Xi’an. There is a small-scale survey conducted in 2005 that showed a 5.2% (84/1626) prevalence of NE among school-age children. To date, there are no large-scale epidemiological surveys of NE in Xi’an. Moreover, cultural awareness has led to greater acceptance of NE as a problem, which allows many children and/or parents to open about the problem. Economic development may make parents more attentive towards child’s health, and their awareness of NE makes them consider NE to be a developmental problem for their child. Fortunately, economic development and cultural improvement are promoting increased attention to NE among parents and medical professionals. However, most parents have a casual attitude towards this condition, and lack awareness of medical treatment, which ultimately causes delay in treatment. Also, NE brings greater economic burden and mental pressure to families. Although NE does not cause physical problems, and 10–15% of enuretic children recover spontaneously, parents and medical practitioners cannot ignore the negative influence of NE on a child’s social, emotional, and psychological development. A study has confirmed that infants who use DD and receive toilet training within the age of 12 months have better control over urination than those who delay toilet training. In rural areas, some children even receive toilet training within 6 months of birth. However, in traditional Chinese culture, parents usually begin toilet training before children’s first birthday. Because of the advent of DD, more and more parents start toilet training after their children’s second birthday. In western countries, parents initiate toilet training depending on a child’s physical and psychological development, usually between the age of 21 and 36 months. With the use of DD, toilet training may be delayed. The risk factors for NE include long-term use of disposable diaper (DD), being male, difficulty in awakening at night, mental stress, poverty, and family environment. In China, NE prevalence was found to vary by region, ranging from 4.07 to 10.3%, and NE occurred more frequently with boys. found that the prevalence of NE in Spanish school-age children was 7.8%. In Turkey, the overall occurrence of NE was 7.5–16.2%, and, in Iran, the prevalence was 8–18.7%. found the prevalences of NE in rural and urban areas were 17.5 and 18.4%. Contributing elements include family history of NE, changes in antidiuretic hormone secretion rhythm, sleep disorders, retarded bladder maturity, immature nerve development, psychology, and environment. The pathogenesis of NE is complex and multifactorial. A supportive parental attitude towards NE and timely medical treatment can improve the quality of life of enuretic children.Ĭhildhood nocturnal enuresis (NE) refers to the symptoms of intermittent urinary incontinence during sleep, at a minimum age of 5 years, with a minimum duration of three months, and a minimum of one episode per month. NE was closely associated with a family history of NE, being male, long-term use of DD, delayed toilet training, drinking sugary beverages and/or consuming little plain water, and sleep disorders. Sleep disorders, sweets intake, drinking low amounts of plain water during the day, and family history of NE, were statistically associated with NE. Children experienced more NE if they never accepted toilet training (7.83%) or if they drank sugary beverages during the day (5.36%). However, the prevalence increased with duration of DD use. The prevalence rates of NE decreased with age, with the highest prevalence at age 5 (9.09% for boys 6.03% for girls). The study included 6568 children ages 5–12 years, of which 262 (3.99%) had NE. Logistic regression analysis was used to calculate odds ratio and to determine risk factors of NE. We used univariate analysis to compare the prevalences of characteristics such as gender, duration of disposable diaper (DD) use, toilet training onset time, daily living habits, academic performance, and family history of NE. MethodsĪ stratified cluster sampling method was used to conduct a cross-sectional study of NE in 10 kindergartens and 20 primary schools in Xi’an. The aim of this study was to investigate the prevalence and risk factors of NE among children ages 5–12 years in Xi’an, China. With economic development and cultural improvements, parents and medical professionals pay more attention to NE. Nocturnal enuresis (NE) has a negative impact on children’s health and imposes a long-term burden on families.

Pediatric enuresis