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Children born to mothers receiving chronic dialysis, a national French cohort (2013-2021)
Hayet Baouche1, Cécile Couchoud2, Olivier Moranne3,4
1Biostatistics Department, APHP-Necker-Enfants Malades Hospital, Renal Epidemiology and Information Network Registry, Paris, France.
Insights
Children born to mothers on chronic dialysis face increased risks of morbidity, including respiratory and digestive issues. Congenital malformations were also noted, warranting further investigation into these outcomes.
Area of Science:
- Pediatric Nephrology
- Maternal-Fetal Medicine
- Public Health
Background:
- Limited data exists on children born to mothers undergoing chronic dialysis.
- Intrauterine exposure to uremic toxins and maternal therapies may pose risks.
- Understanding these risks is crucial for pediatric health outcomes.
Purpose of the Study:
- To investigate the short and mid-term health outcomes of children born to mothers on chronic dialysis.
- To assess the impact of intrauterine exposure on pediatric morbidity.
Main Methods:
- National observational study utilizing the French National Health Data System.
- Analysis of data from 2013-2021.
Main Results:
- 70 live births recorded; 42.9% were preterm.
- Neonatal complications included respiratory distress (7.1%) and NICU admissions (7.1%).
- Common childhood diseases involved respiratory (44.2%), digestive (31.4%), and urinary systems (10%), with a notable rate of congenital malformations (24.2%).
Conclusions:
- Children born to mothers on chronic dialysis exhibit a significant risk of morbidity.
- The observed frequency of congenital malformations requires further validation through larger studies.
Background:
Paediatric data of children born to mothers receiving chronic dialysis are scarce, although this information is essential to study the possible risk of morbidity related to intrauterine exposure to uraemic toxins and maternal therapies. Our aim was to examine the impact of this exposure on the short- and mid-term outcomes of children.
Methods:
This national observational study was based on data from the French National Health Data System.
Results:
In France, over the period 2013-2021, 70 live births were born to mothers receiving chronic dialysis. The median gestational age was 37 weeks [interquartile range (IQR) 33-39], including 40 (57.1%) full-term and 30 (42.9%) preterm births. The median birthweight was 2615 g (IQR 1941-3448) and 32 (45.7%) newborns had a birthweight <2500 g. Other neonatal complications were respiratory distress syndrome [n = 5 (7.1%)], small for gestational age [n = 2 (2.8%) and admissions to the neonatal intensive care unit [n = 5 (7.1%)]. From birth to 8 years of age, the main diseases were those of the respiratory system [n = 31 (44.2%)], including acute bronchiolitis [n = 22 (31.4%)]; diseases and infections of the digestive system [n = 22 (31.4%)], including enteritis and gastroenteritis [n = 14 (20%)]; diseases of the urinary system [n = 7 (10%)], including tubulointerstitial nephritis [n = 5 (7.1%)]; and congenital malformations [n = 17 (24.2%)], including 9 cardiac (12.8%).
Conclusions:
This study highlights the risk of morbidity in children born to mothers on chronic dialysis. Further larger studies are required to confirm the relatively high frequency of congenital malformations.
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