{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:06:16Z","timestamp":1784786776209,"version":"3.55.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary monosymptomatic nocturnal enuresis (PMNE) is a common pediatric condition characterized by involuntary nighttime urination with high spontaneous remission rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe observed changes in PMNE frequency following folic acid supplementation combined with behavioral therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective single-arm cohort study was conducted in Gaza (2023\u20132025). Children aged 5\u201315 years with PMNE received folic acid (5\u2005mg\/day for 3 months) and standardized behavioral therapy. Data were collected using parental bladder diaries. The study is reported in accordance with the STROBE statement for observational cohort studies. All analyses were performed using individual-level paired pre\u2013post data, with no aggregated datasets used for inferential statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 612 children were screened; 500 completed follow-up (loss to follow-up: 5.7%). Mean enuresis frequency decreased from 5.7\u2009\u00b1\u20091.2 to 2.4\u2009\u00b1\u20091.1\u2005episodes\/week (mean difference: 3.2; 95% CI: 3.0\u20133.4;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001; Cohen's\n                      <jats:italic>dz<\/jats:italic>\n                      \u2009=\u20092.78). Complete remission occurred in 42% of participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A reduction in PMNE frequency was observed; however, causal inference cannot be established due to the uncontrolled design and confounding factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1737411","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:39:27Z","timestamp":1784785167000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Folic acid supplementation and observed clinical outcomes in pediatric primary monosymptomatic nocturnal enuresis: a prospective single-arm cohort study from Gaza (2023\u20132025)"],"prefix":"10.3389","volume":"14","author":[{"given":"Sharif Jamal","family":"Salha","sequence":"first","affiliation":[{"name":"Al-Quds University","place":["Abu Dis, Palestine"]},{"name":"Cooperative Society for Medical and Health Services","place":["Gaza, Palestine"]},{"name":"Medical Aid for Palestinians (MAP-UK)","place":["Gaza, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madleen Jawad","family":"Abu Aser","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Al-Israa University","place":["Gaza, Palestine"]},{"name":"Islamic University","place":["Gaza, Palestine"]},{"name":"Al-Ahli Arab Hospital","place":["Gaza, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadallah","family":"Okasha","sequence":"additional","affiliation":[{"name":"School of Public Health, Al-Quds University","place":["Abu Dis, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehia","family":"Abed","sequence":"additional","affiliation":[{"name":"UNRWA Clinics","place":["Gaza City, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al-Aila","sequence":"additional","affiliation":[{"name":"UNRWA Clinics","place":["Gaza City, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahema Imad Jamil","family":"Obaid","sequence":"additional","affiliation":[{"name":"Al-Quds University","place":["Abu Dis, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.juro.2009.10.043","article-title":"Evaluation and treatment of monosymptomatic enuresis: a standardization document","volume":"183","author":"Nev\u00e9us","year":"2010","journal-title":"J Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1002\/nau.22751","article-title":"Standardization of terminology of lower urinary tract function in children","volume":"35","author":"Austin","year":"2016","journal-title":"Neurourol Urodyn"},{"key":"B3","article-title":"Anxiety and nocturnal enuresis","author":"Butler","year":"2008","journal-title":"Scand J Urol Nephrol"},{"key":"B4","article-title":"Sleep and arousal dysfunction in enuresis","author":"Wolfish","year":"2011","journal-title":"Pediatr Clin North Am"},{"key":"B5","article-title":"Folic acid fortification and health outcomes","author":"Crider","year":"2018","journal-title":"Nutrients"},{"key":"B6","article-title":"Folate and neurocognitive effects","author":"Obeid","year":"2019","journal-title":"Clin Chem Lab Med"},{"key":"B7","article-title":"Enuresis: systematic review and management","author":"Caldwell","year":"2019","journal-title":"Lancet Child Adolesc Health"},{"key":"B8","article-title":"Nocturnal enuresis update","author":"Yeung","year":"2020","journal-title":"Nat Rev Urol"},{"key":"B9","article-title":"Update on enuresis treatment guidelines","author":"Austin","year":"2021","journal-title":"J Pediatr Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1016\/j.juro.2014.01.110","article-title":"The standardization of terminology of lower urinary tract function in children and adolescents","volume":"191","author":"Austin","year":"2014","journal-title":"J Urol"},{"key":"B11","volume-title":"Pediatric Folic Acid Supplementation Guidance","year":"2023"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1737411\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:39:28Z","timestamp":1784785168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1737411\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":11,"alternative-id":["10.3389\/fped.2026.1737411"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1737411","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"article-number":"1737411"}}