Bladder and bowel control in a population-based sample: Associations to quality of life and behavioral problems of 4–6-year-old children participating in the German Health Interview and Examination Survey (KiGGS). Issue 2 (April 2020)

• Record Type: Journal Article
• Authors: Hussong, Justine; Rosenthal, Alisha; Wagner, Catharina; Mattheus, Hannah; von Gontard, Alexander
• Is Part Of: Journal of pediatric urology. Volume 16:Issue 2(2020)
• Page Start: 194.e1
• Page End: 194.e9
• Publication Date: 2020-04
• Subjects: Bladder and bowel control -- Incontinence -- Children -- Quality of life -- Psychiatric comorbidity -- KiGGS; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2019.12.017
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Background: Prevalence rates for psychiatric comorbidities are high in incontinent children. We analyzed data from the KiGGS survey in order to assess the rate of preschool children with delayed or regular continence, the mean age of gaining continence, psychiatric problems, and quality of life in a nation-wide, representative sample. Methods: Parental questionnaire data of 3875 preschool children (4–6 years) were analyzed. Percentages of children with daytime, nighttime, and complete continence, and mean ages of gaining continence were calculated. Psychological and behavioral problems (SDQ), as well as Quality of life (KINDL-R), were assessed. Results: 16.9% showed delayed gaining of continence. Percentages of children with nighttime bladder continence were lower for boys (76.3%) than for girls (80.6%), and lower for children without (78.2%) than those with a migration status (79.2%). Complete continence was gained by more girls (83.9%) than boys (78.2%), more children from the former East Germany (82.4%) than former West Germany (81.1%), and by more migrants (82.7%) than nonmigrants (81.9%). Girls, children living in the former East of Germany, and migrants achieved continence consistently at an earlier age. Children with incontinence or continence ≥4 years showed significantly more psychological problems, less prosocial behavior and low quality of life. Conclusion: The age at gaining continence is moderated by gender, German region, and migration status. Delayed achievement of continence is associated with more psychological problems and a lower quality of life. The importance of effective treatment of incontinence is emphasized by the results of this study. Summary Table n a Mean age in months (95% CI) Wald F (df1, df2); p b Complete continence 2073 c 34.1 (33.5–34.7) Girls 1032 32.7 (32.0–33.3) 31.3 (1166); <.001 *** Boys 1041 35.5 (34.7–36.4) Former East Germany 347 29.7 (28.6–30.8) 72.5 (1166); <.001 *** Former West Germany 1726 35.0 (34.4–35.6) Migration status 277 30.0 (28.8–31.3) 45.4 (1166); <.001 *** No migration status 1787 34.7 (34.1–35.3) Continence < 4 years N = 1782 a Incontinence/Continence ≥ 4 years N = 475 a Wald F (df1, df2); p b Mean (95% CI) Mean (95% CI) Total Quality of Life (KINDL) 80.6 (80.2–81.1) 78.7 (77.8–79.6) 14.7 (1166); <.001 ** Total Problem Score (SDQ) 7.9 (7.6–8.1) 9.0 (8.4–9.5) 12.5 (1166); .001 * CI: confidence interval; KINDL: Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen - Revidierte Form; N : number of cases; SDQ: Strengths and Difficulties Questionnaire; Wald F: Wald F-score (Wald Chi-squared Test); P : significance level. a The number of cases refers to weighted data. b Wald F-test. c Total number of cases regarding migration status is n = 2064.