Oliveira E A, Cabral A C, Pereira A K, Machado I N, Diniz J S, Lana A M, Cunha L K
Pediatric Nephrourology Unit, Department of Pediatrics, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Prenat Diagn. 2001 Feb;21(2):129-34.
The purpose of this study was to identify prognostic factors and describe the outcome of prenatally detected renal anomalies associated with multiple malformations and chromosomal defects. Forty-one fetuses were included in the analysis. Prenatal ultrasound reports, neonatal records and autopsy information were retrospectively reviewed. Prognostic factors associated with fetal echography and clinical and laboratory findings on admission were studied. Data were analyzed by univariate analysis in which variables associated with adverse outcome were identified by the Chi-square test or Fisher exact test. The abnormalities associated with renal anomalies were divided into three groups: chromosomal defects (21%), previously described syndromes and conditions (24%), and new sporadic conditions (55%). Of 41 children admitted, 30 (76%) died during the perinatal period. The presence of oligohydramnios was significantly associated with an adverse outcome (OR=11, p=0.05). Male gender was a protective factor against death during the perinatal period (OR=0.11, p=0.01). In conclusion, prenatally detected renal anomalies associated with multiple malformations and chromosomal defects had a poor prognosis. The presence of oligohydramnios increased the risk of death, and male gender had a protective role against poor outcome.
本研究的目的是确定预后因素，并描述产前检测到的与多种畸形和染色体缺陷相关的肾脏异常的结局。41例胎儿纳入分析。对产前超声报告、新生儿记录和尸检信息进行回顾性分析。研究了与胎儿超声检查以及入院时临床和实验室检查结果相关的预后因素。采用单因素分析对数据进行分析，通过卡方检验或Fisher精确检验确定与不良结局相关的变量。与肾脏异常相关的异常分为三组：染色体缺陷（21%）、先前描述的综合征和病症（24%）以及新的散发性病症（55%）。41例入院儿童中，30例（76%）在围产期死亡。羊水过少与不良结局显著相关（OR=11，p=0.05）。男性是围产期死亡的保护因素（OR=0.11，p=0.01）。总之，产前检测到的与多种畸形和染色体缺陷相关的肾脏异常预后不良。羊水过少会增加死亡风险，而男性对不良结局具有保护作用。
