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Maternal Risk Factors for Infants Born with Congenital Renal and Urinary Tract (CAKUT) Anomalies: A Cross-Sectional
N Akand1, P K Sarkar, M J Alam
1Dr Nabila Akand, Assistant Professor, Pediatric Respiratory Medicine (Pulmonology), Bangladesh Shishu Hospital & Institute,
Insights
Maternal pregestational overweight, diabetes, and gestational oligohydramnios are key risk factors for Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) in infants. Identifying these factors is crucial for early intervention and improved outcomes.
Area of Science:
- Pediatrics
- Nephrology
- Public Health
Background:
- Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) are a significant cause of pediatric renal failure.
- The precise pathophysiology of CAKUT remains incompletely understood.
- Maternal health factors are increasingly recognized as potential contributors to CAKUT development.
Purpose of the Study:
- To determine the prevalence of maternal risk factors in infants diagnosed with CAKUT.
- To identify specific pregestational and gestational risk factors associated with CAKUT.
Main Methods:
- A cross-sectional study involving 200 infants with CAKUT (≤60 days old) was conducted over six months.
- Data were collected using a semi-structured questionnaire from mothers.
- Statistical analysis was performed using SPSS version 21.0.
Main Results:
- The most common CAKUT anomalies included primary vesico-ureteral reflux (38.0%) and pelvi-ureteric junction obstruction (20.0%).
- Pregestational maternal risk factors identified were overweight (76.0%), diabetes mellitus (32.5%), and hypertension (29.5%).
- Gestational risk factors included oligohydramnios (87.5%), gestational diabetes mellitus (67.0%), and gestational hypertension (45.5%).
Conclusions:
- Maternal pregestational overweight, diabetes, and gestational oligohydramnios are strongly associated with CAKUT in infants.
- These findings highlight the importance of maternal health monitoring during pregnancy for preventing CAKUT.
Abstract:
Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) often results in renal failure. Alhough the pathophysiology of CAKUT is still not completely understood, several maternal risk factors have been identified associated with children with CAKUT so far. Therefore, the aim of this study was to assess the proportion of risk factors of mothers gave birth to the infants with CAKUT. This cross-sectional study was conducted over a six-month period in the Departments of Pediatrics, Pediatric Nephrology, Neonatology and Pediatric Urology in Dhaka Shishu Hospital, Bangladesh from May 2018 to November 2018. A total of 200 infants aged ≤60 days and with a confirmed diagnosis of CAKUT were included in this study. Informed ascend was taken from the parents of the child. A semi-structured questionnaire was used for data collection, and statistical analysis was performed using SPSS version 21.0. This research was undertaken in conjunction with the ethical principles of Declaration of Helsinki. The mean age of the infants with CAKUT was 22.25±15.08 (SD) days with a male to female ratio of 1:1. The presenting anomalies were primary vesico-ureteral reflux (38.0%), pelvi-ureteric junction obstruction (20.0%), agenesis of the kidney (16.0%), posterior urethral valve (12.0%), dysplasia of the kidney (10.0%) and multicystic dysplastic kidney (3.5%). The most common pregestational risk factors were overweight (76.0%), diabetes mellitus (32.5%) and hypertension (29.5%) among the mothers. On the other hand, oligohydramnios (87.5%), gestational diabetes mellitus (67.0%) and gestational hypertension (45.5%) were the most frequently identified gestational risk factors. Pregestational overweight in women, maternal diabetes and oligohydramnios were most commonly identified risk factors among the mothers of CAKUT infant.
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