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Decreased renal function among children born to women with obstructed labour in Eastern Uganda: a cohort study
David Mukunya1, Faith Oguttu1, Brendah Nambozo1
1Busitema University.
Insights
Children born after obstructed labor show high rates of impaired kidney function. This highlights the need for improved perinatal care and regular monitoring of these children for early detection of renal issues.
Area of Science:
- Pediatric Nephrology
- Obstetrics and Gynecology
- Global Health
Background:
- Chronic kidney disease (CKD) affects over two million children globally.
- Early life insults, like birth asphyxia, may increase CKD risk.
- This study investigated renal function in children born to mothers with obstructed labor.
Approach:
- A cohort of 144 children aged 2-4 years, born to mothers with obstructed labor in Uganda, was followed.
- Renal function was assessed using estimated glomerular filtration rate (eGFR) calculated via the Schwartz formula.
- Decreased renal function was defined as eGFR < 90 ml/min/1.73m².
Key Points:
- The mean age of children was 2.8 years; 66.7% were male.
- Mean umbilical lactate at birth was 8.9 mmol/L.
- A significant 68.8% of children exhibited reduced eGFR, with 67.4% showing mild impairment.
Conclusions:
- High incidence of impaired renal function observed in children born to mothers with obstructed labor.
- Routine follow-up of these children is recommended.
- Improved intrapartum and peripartum care is crucial to mitigate risks.
Background:
Over two million children and adolescents suffer from chronic kidney disease globally. Early childhood insults such as birth asphyxia could be risk factors for development of chronic kidney disease in infancy. Our study aimed to assess renal function among children aged two to four years, born to women with obstructed labour.
Methods:
We followed up 144 children aged two to four years, born to women with obstructed labor at Mbale regional referral hospital in Eastern Uganda. We used estimated glomerular filtration rate (eGFR) by the Schwartz formula to calculate eGFR (0.413*height)/ serum creatinine as a measure of renal function. eGFR less than 90 ml/min/1.73m2 was classified as decreased renal function.
Results:
The mean age of the children was 2.8 years, standard deviation (SD) of 0.4 years. Majority of the children were male (96/144: 66.7%). The mean umbilical lactate level at birth among the study participants was 8.9 mmol/L with a standard deviation (SD) of 5.0. eGFR values ranged from 55 to 163ml/min/1.72m2, mean 85.8 ± SD 15.9. One third (31.3%) 45/144 had normal eGFR (> 90 ml/Min/1.72m2), two thirds (67.4%) 97/144 had a mild decrease of eGFR (60-89 ml/Min/1.72m2), and only 2/144 (1.4%) had a moderate decrease of eGFR. Overall incidence of reduced eGFR was 68.8% (99/144).
Conclusion:
We observed a high incidence of impaired renal function among children born to women with obstructed labour. We recommend routine follow up of children born to women with obstructed labour and add our voices to those calling for improved intra-partum and peripartum care.
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