Risk Factors Associated With Renal and Urinary Tract Anomalies Delineated by an Ultrasound Screening Program in Infants

Abstract

ObjectiveTo evaluate the value of ultrasound screening for congenital anomalies of the kidney and urinary tract (CAKUT) during the early postnatal period.MethodsThis is a prospective study that enrolled all neonates born from August 2019 to July 2020 at one medical center. Postnatal ultrasound screening was conducted in all neonates at 1, 3, and 6 months old, respectively. Information on antenatal detection and pregnancy was collected. We performed logistic regression analyses and established a predictive model to assess the potential risk factors of abnormal ultrasound screening results.ResultsPostnatal ultrasound scanning in 4,877 infants identified 268 cases (5.5%) of anomalies of kidney and urinary tract by primary screening and 92 cases (1.9%) by tertiary screening. A specific diagnosis was identified in 47 cases within the 6-month screening and follow-up program. Logistic regression revealed that preterm birth, oligohydramnios, antenatal ultrasound screening anomalies, and gestational hypothyroidism were independent risk factors for the early detection of CAKUT by postnatal ultrasound screening. The above factors were adopted to develop a predictive model that showed good calibration in predicting ultrasound findings of CAKUT. Decision curve analysis demonstrated good clinical utility.ConclusionsPostnatal ultrasound screening should be conducted in infants with risk factors associated with CAKUT. Further study on prenatal and fetal factors could help establish the predictive model for the early detection of CAKUT.

Factors associated with clinically apparent congenital urethra anomalies among pediatric patients attending Muhimbili National Hospital, Dar Es Salaam, Tanzania

“…In one study Bhat et al reported that low birth weight and preterm birth were significantly associated with genitourinary anomalies [29]. Similar findings were reported in other different studies [1,28]. Contrary to our findings where majority (67.0%) of the patients had normal birth weight during their delivery, and 86.2% of them were born at term, these factors were not statistically significant risk factor, hence warranting further studies in our setting to provide evidence.…”

“…Low birth weight and prematurity have been associated with severe morbidity and congenital anomalies including genito-urinary system [28]. In one study Bhat et al reported that low birth weight and preterm birth were significantly associated with genitourinary anomalies [29].…”

Epidemiological and clinical characteristics, management, and outcomes of antenatal hydronephrosis: A single-centre experience of 229 cases

“…Several previous studies evaluated the risk factors associated with CAKUT. In one of those, Liu et al (7) reported that male gender, preterm birth, abnormal antenatal USG, gestational hypothyroidism, and oligohydramnios were associated with increased CAKUT risk during pregnancy. Our results partly supported these risk factors, which the majority of our cases were male, and all had abnormal antenatal urinary system USG findings.…”

Disease mechanisms of monogenic congenital anomalies of the kidney and urinary tract

“…For example, a recent prospective study from China of 4,877 infants identified 268 cases (5.5%) of CAKUT by primary screening and 92 cases (1.9%) by tertiary screening. This study devised a predictive model incorporating high risk factors, namely male gender, preterm birth, antenatal abnormal ultrasound findings, gestational hypothyroidism, and oligohydramnios, all of which increase the risk of CAKUT (Liu et al, 2022).…”