Evidence map›Paper›PMID 41397815›Full record

ArticleBMJ paediatrics open2025

Examining causal pathways between family adversity and soiling: a prospective cohort study.

Kimberley Burrows, Jon Heron, Davina Richardson, Juliette Rayner, Christine Spray, Carol Joinson

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Article in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kimberley BurrowsCentre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK kimberley.burrows@bristol.ac.uk.ORCID http://orcid.org/0000-0002-3208-0389
Jon HeronCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0001-6199-5644
Davina RichardsonChildren's Nurse Specialist, Bladder and Bowel UK, The Toilet Training Team, UK.
Juliette RaynerERIC, The Children's Bowel and Bladder Charity, 36 Old School House, Kingswood Foundation, Brittania Rd, Bristol, UK.
Christine SprayPaediatric Gastroenterology Department, Bristol Royal Hospital for Children, Bristol, UK.ORCID http://orcid.org/0000-0002-2885-9146
Carol JoinsonCentre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectiveWe aimed to examine the associations between family adversity in infancy and subsequent daytime soiling at primary school age. We also examined factors on the causal pathway between family adversity and soiling, specifically the child's emotional/behaviour problems and constipation.

designThis prospective cohort study included children from the Avon Longitudinal Study of Parents and Children (N=10 033) with data on the Family Adversity Index (FAI; birth to age 2), daytime soiling at age 7.5, emotional/behaviour problems at age 4, and constipation at age 6. We examined the relationships between the FAI, soiling, emotional/behaviour problems and constipation. We then evaluated the mediating effects of emotional/behaviour problems and constipation. All analyses were adjusted for child and family-related confounders.

resultsDaytime soiling occurred in 7% of children. A one-unit increase in infancy FAI was associated with increased odds of 12% for daytime soiling at age 7.5 (OR 1.12, 95% CI 1.07 to 1.17), emotional/behaviour problems score at age 4 (beta 0.52, 95% CI 0.47 to 0.58) and increased odds of constipation at age 6 (OR 1.07, 95% CI 1.03 to 1.11). The presence of constipation at age 6 was strongly associated with increased odds of soiling at age 7.5 (OR 3.34, 95% CI 2.68 to 4.16). There was weak evidence that the associations between FAI and daytime soiling were mediated by emotional/behaviour problems and constipation (OR

conclusionsClinicians should be aware that exposure to family adversity in the early years places children at greater risk of subsequent constipation and soiling.

Indexed as

Adverse Childhood ExperiencesChild Behavior DisordersConstipationFecal IncontinenceChildChild, PreschoolFemaleHumansInfantLongitudinal StudiesMaleProspective StudiesRisk FactorsChild HealthEnuresisEpidemiologyStatistics

Identifiers

PMID41397815
PMCPMC12719889

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