Fatores associados à enurese primária: a associação com o tempo de aleitamento materno exclusivo

Abstract

Introduction: Enuresis is defined as an intermittent urinary incontinence during sleep, and is considered a disease to children who are at least 5 years old. Several factors have been demonstrated to be associated with primary enuresis. Studies indicate that the risk of having enuresis declines with increasing age, it is more common among boys than girls and among individuals from lower socioeconomic levels. Furthermore, other studies highlight the importance of hereditary factors. Although the relationship between enuresis and breastfeeding is still poorly documented in the literature, a possible association is speculated since both are strongly associated with children's development. In this context, the main objective of this study was to evaluate whether there is an association between primary enuresis and the duration of exclusive breastfeeding and the duration of breastfeeding. Methods: This is an observational, case-control study, involving 200 infants from 6 to 14 years old, which were divided into two groups, enuresis group (EG), composed of 100 children with primary enuresis and the control group (CG) of 100 matched children without enuresis. The matching criteria were gender, age and socioeconomic level. Adults responsible for each infant answered a structured questionnaire to identify biological and behavioral factor, as well as the duration of maternal breastfeeding. Children whose parents couldn't comprehend the questionnaire or children with neurological, psychiatrically or secondary enuresis were not included in the study. Results: In each group there were 37 females and 63 male (p=1.0). The mean age were similar in both groups 8,81 ± 2,42 (p=1.0), as well as the socio-economic level (p=0.82). In bivariate analysis, there was a strong association between symptoms of enuresis to a positive family history of enuresis and duration of exclusive breastfeeding (p <0.001), also was associated with full breastfeeding duration (p=0.044), number of children (p=0.045) and parents' education (p=0.045). After logistic regression, primary enuresis continued associated with duration of exclusive breastfeeding and family history of enuresis. The odds ratio was calculated and found that exclusive breastfeeding for less than four months increased 3.35 times the chance of the child has enuresis when compared to those breastfed for a period equal to or exceeding this [1.99- 9.50] 95%CI. Conclusions: This study confirmed the association between primary enuresis and family history of enuresis. A new factor, the duration of exclusive breastfeeding for less than four months, was associated with primary enuresis. The duration of breastfeeding, number of children, birth order and educational level of household head were not associated with primary enuresis.