Maternal diabetes and renal agenesis/dysgenesis

Renal agenesis and dysgenesis are potentially lethal congenital malformations affecting 2 to 5 infants per 10,000 live births annually in the United States. The low prevalence of these malformations has complicated understanding of potential risk factors. Maternal diabetes (type 1, type 2, and gestational) has been evaluated extensively as a risk factor for other congenital malformations, but only a limited number of studies have assessed the association between diabetes and renal agenesis.

We conducted a population-based case-control study of deliveries after 20 weeks gestation in Texas Health Service Region 6 (Houston/Galveston area) from January 1, 2000 to December 31, 2002. Cases of renal agenesis/dysgenesis (n = 89) were ascertained from the Texas Birth Defects Registry. Cumulative incidence sampling was used to randomly select, from birth and fetal death records, 356 controls frequency matched to cases by delivery year and vital status. Maternal diabetes and other covariates were collected from vital records.

The odds of renal agenesis/dysgenesis were 3.1 (95% confidence interval [CI], 1.1-9.3) times greater among deliveries of mothers with diabetes compared to deliveries of mothers without diabetes, controlling for matching factors.

Our results are consistent with prior, but limited, research identifying diabetes as a risk factor for renal agenesis/dysgenesis. While these data did not differentiate diabetes diagnoses by type, the results suggest that maternal diabetes may be associated with renal malformations. Further study is warranted.