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Frequency and short-term persistence of haematuria and/or proteinuria in neonates: a cohort study
Jochen Kittel1, Christine Seilbeck2, Susanne Brandstetter2,3
1University of Regensburg, Children's Hospital (KUNO), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany. jochen.kittel@klinik.uni-regensburg.de.
Insights
In healthy newborns, 27% showed temporary haematuria or proteinuria. These urinary findings resolved within weeks, suggesting isolated results in neonates require cautious interpretation.
Area of Science:
- Neonatal research
- Pediatric nephrology
- Clinical diagnostics
Background:
- Previous studies focused on school-aged children, leaving neonatal prevalence of haematuria and proteinuria largely uninvestigated.
- Data on the frequency and persistence of haematuria and/or proteinuria in the general neonate population are scarce.
Purpose of the Study:
- To systematically investigate the frequency and persistence of haematuria and/or proteinuria in asymptomatic neonates.
- To explore factors associated with these urinary findings in newborns.
Main Methods:
- Prospective KUNO-Kids Health Study involving urine dipstick analysis in neonates (3-5 days old).
- Positive findings were followed up to twice within 16 weeks of age.
- Exploration of factors linked to haematuria and/or proteinuria.
Main Results:
- 27% of 509 neonates had positive urine test results (haematuria, proteinuria, or both).
- Follow-up revealed transient results, with 1.9% positive at 7 weeks and none at 10 weeks.
- Positive results were more frequent in females and after vaginal delivery (p<0.001 and p=0.037).
Conclusions:
- A significant proportion of healthy newborns exhibit transient haematuria and/or proteinuria shortly after birth.
- Urinary findings normalized within weeks in all followed-up participants.
- Isolated haematuria and/or proteinuria in newborns should be interpreted cautiously due to their transient nature.
Purpose:
Haematuria and proteinuria may point to kidney diseases, but may also be found incidentally. Among schoolchildren, many studies suggest their prevalence to around 1%. In neonates, the frequency and persistence of haematuria and/or proteinuria in the general population have so far not been investigated systematically.
Methods:
In the course of the prospective KUNO-Kids Health Study, urine samples were collected and analysed by dipstick in asymptomatic neonates on days three to five after birth. Those with positive findings underwent a maximum of two follow-ups until 16 weeks of age and factors associated with haematuria and/or proteinuria were explored.
Results:
Of 509 participants with a urine sample available, 27% (n = 139) exhibited positive results. Of these, 58% (n = 81) had isolated haematuria, 21% (n = 29) had isolated proteinuria, and 21% (n = 29) had both. Of all children with positive urine tests, 76% (n = 105) underwent a first follow-up (mean 7 weeks later), and only in 1.9% (n = 2) was a positive result found. In the second follow-up (mean 2 weeks later), no positive results were detected anymore. Positive urine test results were more common in females and after vaginal delivery (p < 0.001 and p = 0.037, respectively).
Conclusion:
The present study identified haematuria and/or proteinuria in a significant proportion of healthy newborns shortly after birth, but results returned to normal within weeks in all participants available for follow- up. Thus, isolated findings of haematuria and/or proteinuria in newborns should be interpreted with caution.
What Is Known:
• Previous studies have reported the prevalence and persistence of haematuria and/or proteinuria in school- age children, but data on haematuria and/or proteinuria in neonates are scarce.
What Is New:
• Positive urinary test results for haematuria and/or proteinuria are common after birth and were found in 27%. • Positive urinary test results returned to normal within 16 weeks in all children tested.
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