Walsh Thomas J, Hsieh Stephanie, Grady Richard, Mueller Beth A
Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.
Urology. 2007 May;69(5):970-4. doi: 10.1016/j.urology.2007.01.062.
To assess the risk of hospitalization for pyelonephritis within the first year of life among infants with and without antenatal hydronephrosis.
A retrospective cohort analysis was performed using linked birth-hospital discharge records from Washington State for 1987 to 2002 to evaluate the risk of hospitalization in the first year of life for pyelonephritis among infants with and without hydronephrosis. Eligible infants had mothers who had prenatal ultrasound screening. A total of 522 singleton infants with antenatal hydronephrosis (International Classification of Diseases, Ninth Revision code 753.2) at the birth hospitalization were identified. For comparison, 2610 singletons without hydronephrosis were selected. We screened hospital discharge records for 1 year after delivery to identify hospitalizations for pyelonephritis and estimate the relative risk (RR) among infants with and without hydronephrosis.
Five percent of infants with antenatal hydronephrosis and 1% of those without had pyelonephritis-related hospitalizations in their first year (RR 11.8, 95% confidence interval [CI] 6.8 to 20.5). Among girls the RR was 36.3 (95% CI 10.6 to 124.0); among boys it was 5.3 (95% CI 2.2 to 13.1). In infants with hydronephrosis, girls were more likely to be hospitalized with pyelonephritis (odds ratio 2.9, 95% CI 1.2 to 6.9).
Infants with antenatal hydronephrosis are nearly 12 times more likely to have pyelonephritis-related hospitalizations in the first year of life. This association is stronger in girls. Parents and healthcare providers of infants with this diagnosis should be vigilant for the signs and symptoms of urinary tract infections.
评估有和没有产前肾积水的婴儿在出生后第一年内发生肾盂肾炎住院的风险。
采用回顾性队列分析，利用华盛顿州1987年至2002年的出生-医院出院关联记录，评估有和没有肾积水的婴儿在出生后第一年内因肾盂肾炎住院的风险。符合条件的婴儿其母亲进行了产前超声筛查。在出生住院时共确定了522名单胎产前肾积水婴儿（国际疾病分类第九版编码753.2）。为作比较，选择了2610名单胎无肾积水婴儿。我们筛查了分娩后1年的医院出院记录，以确定肾盂肾炎住院情况，并估计有和没有肾积水婴儿的相对风险（RR）。
产前肾积水婴儿中有5%在出生后第一年内因肾盂肾炎住院，无肾积水婴儿中这一比例为1%（RR 11.8，95%置信区间[CI] 6.8至20.5）。女孩中的RR为36.3（95% CI 10.6至124.0）；男孩中的RR为5.3（95% CI 2.2至13.1）。在有肾积水的婴儿中，女孩因肾盂肾炎住院的可能性更大（优势比2.9，95% CI 1.2至6.9）。
产前肾积水婴儿在出生后第一年内因肾盂肾炎住院的可能性几乎高12倍。这种关联在女孩中更强。患有此诊断的婴儿的父母和医疗保健提供者应警惕尿路感染的体征和症状。
