Trajectories of urinary incontinence in childhood and bladder and bowel symptoms in adolescence: prospective cohort study.
Trajectories of urinary incontinence in childhood and bladder and bowel symptoms in adolescence: prospective cohort study.
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DOI：
10.1136/bmjopen-2016-014238
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发表时间：
2017-03-14
期刊：
影响因子：
2.9
通讯作者：
Joinson C
中科院分区：
文献类型：
--
作者：
Heron J;Grzeda MT;von Gontard A;Wright A;Joinson C
确定儿童尿失禁的不同模式(轨迹)，并检查哪些模式与青春期的膀胱和肠道症状有关。前瞻性队列研究。一般社区。最初的样本包括8,751名儿童(4,507名男性和4,244名女性)，他们的父母报告的尿床频率和白天尿尿频率的数据至少有五个时间点中的三个(四个半、五个半、六个半、七个半和九个半岁-以下称为4-9 年)。研究儿童在14岁时提供了一系列膀胱和肠道症状的数据(5899名参与者有数据)。在14 年时自我报告的膀胱和肠道症状包括白天尿液、尿床、夜尿、尿急、尿频、排尿量低、排尿延迟、排便困难和大便频率低。我们用纵向潜伏期分析方法提取了4~9 年的5种尿失禁轨迹：(1)白天和夜间膀胱控制的正常发展(样本的63.0%)，(2)延迟实现膀胱控制(8.6%)，(3)单独尿床(不白天尿液)(15.6%)，(4)单独白天尿液(不尿床)(5.8%)和(5)持续尿液(尿床尿伴白天尿液至9岁)(7.0%)。持续尿液类别与青少年膀胱和肠道症状的相关性最强：或14 年尿床=23.5，95%可信区间(15.1~36.5)，白天尿液(6.98(4.5~10.8))，夜间尿尿(2.39(1.79~3.20))，紧迫感(2.10(1.44~3.07))和排出硬便(2.64(1.63~4.27))(参考类别为正常发展)。仅有尿床的儿童与青少年尿床的相关性较弱(3.69(2.21至6.17))。儿童尿失禁的轨迹与青少年的膀胱和肠道症状有不同的相关性。持续尿床和白天尿尿的儿童在青春期的结果最差。
To identify different patterns (trajectories) of childhood urinary incontinence and examine which patterns are associated with bladder and bowel symptoms in adolescence. Prospective cohort study. General community. The starting sample included 8751 children (4507 men and 4244 women) with parent-reported data on frequency of bedwetting and daytime wetting for at least three of five time points (4½, 5½, 6½, 7½ and 9½ years—hereafter referred to as 4–9 years). Study children provided data on a range of bladder and bowel symptoms at age 14 (data available for 5899 participants). Self-reported bladder and bowel symptoms at 14 years including daytime wetting, bedwetting, nocturia, urgency, frequent urination, low voided volume, voiding postponement, passing hard stools and low stool frequency. We extracted 5 trajectories of urinary incontinence from 4 to 9 years using longitudinal latent class analysis: (1) normative development of daytime and night-time bladder control (63.0% of the sample), (2) delayed attainment of bladder control (8.6%), (3) bedwetting alone (no daytime wetting) (15.6%), (4) daytime wetting alone (no bedwetting) (5.8%) and (5) persistent wetting (bedwetting with daytime wetting to age 9) (7.0%). The persistent wetting class generally showed the strongest associations with the adolescent bladder and bowel symptoms: OR for bedwetting at 14 years=23.5, 95% CI (15.1 to 36.5), daytime wetting (6.98 (4.50 to 10.8)), nocturia (2.39 (1.79 to 3.20)), urgency (2.10 (1.44 to 3.07)) and passing hard stools (2.64 (1.63 to 4.27)) (reference category=normative development). The association with adolescent bedwetting was weaker for children with bedwetting alone (3.69 (2.21 to 6.17)). Trajectories of childhood urinary incontinence are differentially associated with adolescent bladder and bowel symptoms. Children exhibiting persistent bedwetting with daytime wetting had the poorest outcomes in adolescence.