Nocturnal enuresis in early adolescence and neurodevelopmental delay in infancy: A population‐based study

Abstract

Abstract Aim The neurodevelopmental delay hypothesis may explain the mechanism of nocturnal enuresis (NE), but whether the hypothesis holds in early adolescence remains unknown, considering NE frequency. Therefore, we aimed to identify whether neurodevelopmental delays in infancy were associated with the frequency of NE in early adolescence. Methods Data were extracted from the Tokyo Early Adolescence Survey, in which 4478 children (mean age: 10.2 years) and their parents participated. Twelve developmental delays (eight motor, four verbal) were extracted from the Maternal and Child Health Handbook. The NE frequency was obtained from a parent‐answered questionnaire, which divided children into three categories according to DSM‐5 criteria (none, infrequent [<1 time a week], and frequent [≥2 times a week]). Multinomial logistic regression analysis was performed to determine whether delayed developmental milestones in infancy were predictive of frequent/infrequent NE in early adolescence. Results Developmental delays, particularly those related to motor development but not verbal, such as holding their head up (odds ratio [95% confidence interval] = 2.1 [1.1–4.2]), crawling (2.1 [1.0–4.4]), walking with support (4.0 [1.9–8.4]), walking independently (5.8 [2.2–15.4]), and drawing a circle (5.0 [2.0–12.3]), were significantly associated with an increased risk of frequent NE in early adolescence (all ps < 0.05). However, an association with infrequent NE was not found. Conclusion This population‐based epidemiological study revealed that motor developmental delays increased the risk of frequent NE in early adolescence, but not of infrequent NE. This finding reinforces the neurodevelopmental delay hypothesis, which provides a biological explanation for the involuntary nature of enuresis. All children in early adolescence with frequent NE should be evaluated and treated by a medical expert.

Keywords

• adolescence
• epidemiology
• motor development
• nocturnal enuresis
• Tokyo Early Adolescence Survey