Association Between Non-hemolytic Anemia and Urinary Incontinence in Children Over 3 Years: A Case-control Study Association Between Non-hemolytic Anemia and Urinary Incontinence
Journal of Pediatric Nephrology,
Vol. 12 No. 1 (2024),
10 Farvardin 2025
https://doi.org/10.22037/jpn.v12i1.46514
Abstract
Background and Aim: Urinary incontinence represents a significant pediatric health concern
affecting children beyond the age of expected physiological control, with a substantial
impact on quality of life. Anemia, particularly iron deficiency, is a widespread global health
issue affecting a large proportion of children worldwide. This study aimed to evaluate the
association between non-hemolytic anemia and urinary incontinence in children over three
years of age.
Methods: This case-control study included 260 children aged 3-16 years, divided into two
equal groups: 130 children with non-hemolytic anemia (hemoglobin <11 g/dL) and 130 ageand
sex-matched healthy controls. Participants were assessed for various types of urinary
incontinence through structured interviews with parents using standardized questionnaires.
Statistical analysis included the chi-square test, descriptive statistics, and logistic regression
analysis to calculate odds ratios.
Results: While general urinary incontinence showed no significant association with anemia
(OR: 1.32; 95% CI, 0.81-2.16), monosymptomatic enuresis was significantly more prevalent
in the anemic group (30.8% vs. 6.2%, P<0.001), with an odds ratio of 6.77 (95% CI, 3.02-
15.18). Conversely, underactive bladder was less common in anemic children (10.0% vs.
19.2%, P=0.035, OR: 0.46, 95% CI, 0.22-0.95). Among anemic children with urinary
disorders, iron deficiency was the most common type, present in 49.4% of cases with urinary
incontinence and 52.5% of cases with monosymptomatic enuresis.
Conclusion: This study provides evidence for a significant association between nonhemolytic
anemia and monosymptomatic enuresis in children over three years of age.
Anemia screening should be considered in children presenting with monosymptomatic
enuresis, particularly in regions with high rates of iron deficiency. Future research should
explore the mechanisms behind these associations and assess whether treating anemia can
improve enuresis symptoms.
- Urinary incontinence
- Pediatrics
- Enuresis
How to Cite
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