Prenatal Risk Factors for Congenital Anomalies of the Kidney and Urinary Tract

OBJECTIVE: Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of chronic renal disease in childhood. Abnormal intrauterine conditions as well as genetic disorders play role in CAKUT development. We evaluated antenatal factors in CAKUT.

MATERIAL and METHODS: The study and control groups included 140 CAKUT cases and 140 children without urinary malformation, respectively. Both groups were compared for antenatal (gestational period, prematurity, oligohydramios, preeclampsia, gestational diabetes, accompanying malformation, in vitro fertilization), maternal (age, body weight at pregnancy onset, weight gain during pregnancy, systemic disease, smoking, alcohol, medications) and familial (consanguinity, renal disease, urinary malformation) parameters.

RESULTS: The study group had a shorter gestational period (38.8±2.9 vs. 39.5±0.9 week, p=0.004), but higher prematurity (9.3% vs. 0.7%, p=0.001), parity (≥2 parity 57.9% vs. 41.4%, p=0.006), oligohydramnios (6.4% vs. 0%, p=0.002), accompanying malformation (15.7% vs. 5.7%, p=0007), weight gain in pregnancy (18.8±2.9 vs. 18.1±2.8 kg, p=0.047) and familial renal disease (7.9% vs. 2.1%, p=0.028) rates. In vitro fertilization was present in only two cases in the study group.

CONCLUSION: Weight gain in pregnancy and increased parity may be risk factors for CAKUT. Population-based studies are needed to determine the role of subfertility.