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[Gestational diabetes and urinary tract malformations: a hospital case-control study]
Arnaud Fotso Kamdem1, Antoine Burguet, Didier Aubert
1Service de Chirurgie Pédiatrique et Orthopédique, Hôpital Saint-Jacques, Besançon, France. afotso@chu-besancon.fr
Introduction:
Urinary tract malformations represent the leading cause of renal failure in children. Gestational diabetes plays a controversial role in the development of urinary tract malformations. The purpose of this study was to assess the role of insulin-requiring gestational diabetes on the development of ureteric malformations in children.
Material And Methods:
The authors report the results of a prospective case-control survey (102 cases, 104 controls) conducted in a teaching hospital. The role of insulin-requiring gestational diabetes on the development of urinary tract malformations was tested by logistic regression after adjustment for risk factors for urinary tract malformations 'family history of urinary tract malformations, parity, smoking, substance abuse during pregnancy).
Results:
Gestational diabetes is a risk factor for urinary tract malfornations after adjustment (aOR=5.1; 95%CI: 1.1-24.5), and for ureteropelvic junction syndrome (aOR=6.5; 95%CI: 1.1-39.4) and vesicoureteric reflux (aOR=5.9; 95%CI: 1.1-32.1).
Conclusion:
All perinatal healthcare professionals must be familiar with the concept of insulin-requiring gestational diabetes as an uncommon, but fairly powerful risk factor for ureteric malformations.