Primary Nocturnal Enuresis and Intelligence Levels in Children: A Meta-Analysis and Systematic Review

Abstract

Background: Primary nocturnal enuresis (PNE) has been hypothesized to be associated with cognitive impairments, particularly in intelligence and working memory. However, the extent and significance of this relationship remain unclear. This meta-analysis aims to systematically examine the association between PNE and cognitive functioning. Methods: A systematic review and meta-analysis were conducted, including 10 studies with a total of 9987 participants (primary nocturnal enuresis = 1758; control = 8229). Cognitive performance, particularly intelligence quotient scores, was analyzed using pooled statistical methods to determine potential differences between groups. Results: Children with PNE exhibited a mean intelligence quotient score 2.44 points lower than control participants. However, this difference did not reach statistical significance (p = 0.261), and the overall effect size was minimal (t = -1.165). The pooled standard deviation was 13.91, indicating substantial variability across studies. Conclusions: While children with PNE tend to have slightly lower intelligence quotient scores than their peers, the results do not suggest a statistically significant impact on global intelligence. However, the consistent trend observed across studies highlights the need for further research to investigate specific cognitive domains that may be affected by enuresis. Future studies should focus on neurodevelopmental mechanisms and explore potential intervention strategies to address any cognitive vulnerabilities associated with this condition.

Keywords: cognitive functioning; intelligence quotient; meta-analysis; neurodevelopment; primary nocturnal enuresis.

Figure 1

PRISMA Flow Diagram.

Figure 2

Forest plot PNE vs. control group intelligence quotient scores [11,13,16,17,28,29,30,31,32,33].