DETERMINANTS OF NOCTURNAL ENURESIS IN ENGLAND AND SCOTLAND IN THE 90S

The aim of this study was to assess whether changes have occurred in t he determinants of nocturnal enuresis in Scotland and England in compa rison with previous studies. The study was based on 22 study areas fro m a representative English sample, 14 areas from a representative Scot tish sample, and 20 areas from an English inner-city sample. A total o f 14 674 subjects was included in the analysis from 16 835 eligible ch ildren in the age range 5 to 11 years. For the main analysis, an enure tic child was one who wet the bed at least once a week. As expected, t he frequency of enuresis was higher in boys and decreased markedly wit h age in both sexes. Bedwetting was more frequent in: Afro-Caribbean c hildren compared with white children in the representative samples (OR 1.72 95% CI 1.22 to 2.42); those whose mothers smoked at least 10 cig arettes at home compared with nonsmokers (OR 1.58 95% CI 1.26 to 1.98) ; children who had disturbed sleep compared with those who slept well (OR 1.96 95% CI 1.53 to 2.51); those with mothers aged less than 20 ye ars at the child's birth compared with mothers in the age range 25 to 34 (OR 1.63 95% CI 1.20 to 2.22); and in the second-or third-born in t he family in comparison with the first-born (OR 1.42 95% CI 1.17 to 1. 72). Father's social class was associated with enuresis only in girls. Only 50% of the parents consulted a doctor for enuresis in their chil d. The percentage was even lower in Afro-Caribbean families (33%). Enu resis continues to be a highly prevalent problem and has not decreased over the last 45 years. We confirm that environmental factors are sti ll important in the aetiology of enuresis. It is surprising that despi te the availability of effective treatment only half of parents consul t a doctor about the problem.