Nocturnal incontinence in children with fetal alcohol spectrum disorders (FASD) in a South African cohort

Sylvia Roozen*, Leana Olivier, Justine Niemczyk, Alexander von Gontard, Gjalt-Jorn Y. Peters, Gerjo Kok, Denis Viljoen, Leopold Curfs

*Corresponding author for this work

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Fetal alcohol spectrum disorders (FASD) are one of the leading preventable causes of intellectual disabilities (ID). Not much is known about the topic of pediatric incontinence related to FASD, for example nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI). So far, incontinence problems have been examined among children with other specific syndromes.


The aim of the present study is to investigate the possible presence of incontinence among children with FASD in a South African cohort.

Study design

The South African version of the combined questionnaire including the "Parental Questionnaire: Enuresis/Urinary Incontinence" and "Encopresis Questionnaire - Screening Version"; and lower urinary tract symptoms (LUTS) were assessed by the "International-Consultation-on-Incontinence-Questionnaire - Pediatric Lower Urinary Tract Symptom" (ICIQ-CLUTS) among 99 interviewees (e.g. mothers, grandparents) of children with FASD. Moreover, scores on the "Griffiths Mental Development Scales - Extended Revised" (GMDS-ER) were obtained of all included children for further statistical analysis.


The overall incontinence rate was 20% (n = 20), in children diagnosed within the FASD spectrum (fetal alcohol syndrome or FAS n = 17, partial fetal alcohol syndrome or pFAS, n = 1, alcohol related neuro-developmental disorder or ARND n = 2). NE affected 16% (n = 16) of children with a FASD (FAS n = 13, pFAS n = 1, and ARND n = 2). DUI was reported in one child (FAS), and FI in 4% (n = 4) of children (again, only FAS). No indication of lower urinary tract symptoms (LUTS) in the clinical range was reported (sample mean score = 5.17). Based on the GMDS-ER, 88% of the children scored lower than 10th percentile.


This is a first study to examine the problems of incontinence among children diagnosed within the spectrum of FASD. The rates for children with a FASD are lower than the rates for many children with special needs, but much higher than for typically developing children. Children with a FASD are mainly affected by NE.


The problem of incontinence among children with a FASD in South Africa needs to be assessed and considered for clinical management. Future research is necessary to examine problems of incontinence in relation to cognitive and behavioral functioning among children with a FASD, as well as identifying possible causes.

Original languageEnglish
Pages (from-to)496.e1-496.e7
Number of pages7
JournalJournal of Pediatric Urology
Issue number5
Early online date23 Mar 2017
Publication statusPublished - Oct 2017


  • Fetal alcohol syndrome
  • Fetal alcohol spectrum disorder(s)
  • Daytime urinary incontinence
  • Nocturnal enuresis
  • Fecal incontinence

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