Risk factors in internal urinary system malformations

Abstract

Risk factors were studied in 370 children with internal urinary system (IUS) anomalies, coming from 105,374 consecutive births of known outcome. The incidence of IUS malformations was 3.51 per 1,000 births. Diagnosis was performed prenatally in 54.4% of patients. Two hundred and fifty-two patients had isolated IUS anomalies; 118 (31.8%) of the children had at least one non-urinary malformation. Fifty-five infants (14.8%) had recognized chromosomal and non-chromosomal syndromes. The more frequent non-urinary malformations were cardiac, digestive and limb anomalies. For each case a control was studied. The following features were assessed: sex ratio, parity and previous pregnancies, parental age, residency, education, ethnic origin, length, head circumference and weight at birth, genetic and environmental factors. Odds ratio values were calculated for risk factors. Weight, length and head circumference at birth were less than in the controls and the weight of the placenta was lower. Pregnancies with IUS anomalies were more often complicated by oligo-amnios and threatened abortions. Oligo-amnios was more frequent in pregnancies in which babies had multiple malformations and recognized syndromes with IUS anomalies. One child of every three with IUS anomalies had an extra-urinary malformation, which is 12 times the incidence of such malformation in our population. There was an increase in consanguinity in the parents of our patients. The incidence of IUS anomalies in first-degree relatives was 2.9%. First-degree relatives had more non-urinary malformations than controls (7.02 vs 3.2%). Our study demonstrated the high capacity of a general ultrasound screening programme to detect fetal malformations affecting the urinary tract.

Maternal smoking and birth defects: Validity of birth certificate data for effect estimation

“…We also found two literature reports for all urinary tract defects combined; one report showed a positive association with maternal smoking 22 and one showed no association with maternal smoking. 23 Maternal smoking was positively associated with the defect category of polydactyly/syndactyly/adactyly in our study, but we did not locate any reports to support this finding. We are unable to separate the defects included in this check box on the birth certificate, and each of these may be etiologically distinct.…”

The Dilemma of Ureterovesical Junction Obstruction

“…Gil Vernet described the normal anatomy of the ureterovesical junction, and explained 3 distinguished segments at this part of the ureter: juxta-vesical, intramural, and sub mucosal segments, associated by Waldeyer's sheath and pre-vesical sphincter (1). After ureteropelvic junction obstruction (UPJO), UVJO is the second most common cause of hydronephrosis in newborns, accounting for approximately 20% of cases, with an estimated incidence of 36 per 100000 live births (2). There are many types of UVJOs, with different causes, presentations, imaging characters, and prognosis.…”

Blood Pressure, Renal Function, and Proteinuria in Children with Unilateral Renal Agenesis

“…Unilateral renal agenesis (URA) is one of the most common urinary tract malformations, occurring in 1: 1,000 to 1: 3,000 newborns [1][2][3] . Patients with URA have a congenitally reduced nephron number that is a known risk factor for the development of hyperfiltration injury such as proteinuria, impaired renal function, and hypertension in experimental models [4,5] .…”