摘要
背景：夜间遗尿症（NE）是一种普遍存在的儿童疾病，与焦虑、内疚和自卑等严重的情绪病有关。值得注意的是，在不同的地域和社会文化背景下，NE 的发病率存在很大差异，从 2% 到 75% 不等，这凸显了环境和社会因素的影响。与之相关的社会耻辱感会加剧情绪困扰，对自我认知和整体生活质量产生负面影响。本系统综述和荟萃分析旨在综合有关NE的全球流行病学数据，考虑国家间流行率的差异，并阐明其相关因素，从而为制定文化敏感性和有效的干预策略提供信息：方法：纳入全球所有针对儿童和青少年开展的观察性定量研究文章。我们使用了 PubMed Central、Cochrane Library、Scopus 和 Google Scholar 等检索数据库。使用纽卡斯尔-渥太华量表检查研究质量。然后使用 I2 统计量和 Cochran's Q 检验来评估异质性。采用随机效应模型，使用漏斗、Egger 检验以及非参数修剪和填充效应检验来检查发表偏倚。最后，还进行了亚组分析以评估统计异质性，并进行了敏感性分析以检测是否存在有影响的研究：在最终分析中，共有 128 项研究，涉及 39 个国家的 445 242 人。儿童和青少年夜间遗尿症的总患病率为 7.2%（95% CI：6.2-8.1%）。阳性家族史 AOR 1.49（95% CI：1.26-1.71）、阳性尿路感染 AOR 3.89，95% CI（2.93-4.46）、父母死亡 AOR = 1.93（95% CI：1.73-2.12）、第一胎 AOR 0.5（95% CI：0.37-0.62）和男性 AOR 1.63；95% CI（1.31-1.94）是儿童和青少年夜遗尿症的重要相关因素：研究发现，约有 7.2% 的儿童和青少年患有夜间遗尿症。在统计学上，家族史、尿路感染、父母死亡、出生顺序和性别都是重要的影响因素。考虑到这些因素对儿童和青少年的重大影响，建议医疗服务提供者对夜间遗尿症进行常规筛查，尤其是对有家族史和尿路感染等已知风险因素的儿童，并应优先制定有针对性的干预措施和支持机制。Background: Nocturnal enuresis (NE), a prevalent childhood condition associated with significant emotional morbidity, including anxiety, guilt, and diminished self-esteem. Notably, NE exhibits substantial variability in prevalence across diverse geographical and sociocultural contexts ranging from 2 to 75%, highlighting the influence of environmental and societal factors. The associated social stigma exacerbates emotional distress, negatively impacting self-perception and overall quality of life. This systematic review and meta-analysis seek to synthesize global epidemiological data on NE, accounting for inter-country prevalence variations, and to elucidate its associated factors, thereby informing the development of culturally sensitive and effective intervention strategies.
Methods: All observational quantitative research articles conducted among children and adolescents in the world were included. We used PubMed Central, Cochrane Library, Scopus, and Google Scholar searching databases. The study quality was checked using the Newcastle - Ottawa Scale. Then I2 statistics and Cochran's Q test were used to evaluate heterogeneity. Funnel, Egger's test, and non-parametric trim and fill effect tests were used to check publication bias by using a random effect model. Finally, subgroup analysis was done to evaluate statistical heterogeneity, and sensitivity analysis was also done to detect the presence or absence of any influential study.
Results: In the final analysis, one hundred twenty-eight studies involving 445,242 individuals in 39 countries. The overall pooled prevalence of Nocturnal enuresis among children and adolescents was 7.2% (95% CI: 6.2-8.1%). Positive family history AOR 1.49 (95% CI: 1.26-1.71), positive urinary tract infection AOR; 3.89, 95% CI (2.93-4.46), parental death AOR = 1.93 (95% CI: 1.73-2.12), first birth order AOR 0.5 (95% CI: 0.37-0.62), and male sex AOR 1.63; 95% CI (1.31-1.94 were the significant associated factors with Nocturnal enuresis among children and adolescent.
Conclusion: The study found that nocturnal enuresis affects approximately 7.2% of children and adolescents. Family history, urinary tract infection, parental death, birth order, and sex were statistically significant factors. It is recommended that healthcare providers should implement routine screening for nocturnal enuresis, particularly for children with known risk factors such as family history and urinary tract infections, and the development of targeted interventions and support mechanisms should be prioritized, considering the significant impacts of these factors among children and adolescents.
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