Gebäck Carin, Hansson Sverker, Martinell Jeanette, Milsom Ian, Sandberg Torsten, Jodal Ulf
Department of Pediatrics, Institute of Clinical Sciences, Gothenburg, Sweden.
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Obstet Gynecol Scand. 2016 Apr;95(4):452-7. doi: 10.1111/aogs.12853. Epub 2016 Feb 18.
Urinary tract infections (UTI) during childhood can result in permanent renal damage, with possible implications for future pregnancies. The aim of this prospective study was to investigate pregnancy outcomes in women followed after their first UTI in childhood.
A cohort of 72 parous women was followed from their first UTI in childhood up to a median age of 41 years. Clinical data were obtained from antenatal and hospital records. Renal damage was evaluated by a (99m) Tc-dimercaptosuccinic acid scan. Pregnancy blood pressure (BP), complications and UTIs were compared between women with and without renal damage.
All women completed the investigations, 48 with and 24 without renal damage. No woman, irrespective of presence or absence of renal damage, was diagnosed with hypertension before the first pregnancy. Pregnancy-related hypertension was diagnosed in 10 of 151 pregnancies, all in women with renal damage. Preeclampsia occurred in four women. Women with renal damage had significantly higher systolic BP measured at the last antenatal visit of their first pregnancy, compared with women without renal damage (p = 0.005). During subsequent pregnancies both systolic and diastolic BP were significantly higher in women with than without renal damage (p = 0.02 and p = 0.03, respectively).
In this population-based follow-up study we found a large proportion of women with renal damage after UTI in childhood. Women with renal damage had significantly higher BP during pregnancy compared with women without renal damage. Pregnancy-related hypertension was recorded only in women with renal damage. However, pregnancy complications, including preeclampsia, were few.
儿童期尿路感染（UTI）可导致永久性肾损伤，可能对未来妊娠产生影响。这项前瞻性研究的目的是调查童年首次患UTI后接受随访的女性的妊娠结局。
对72名经产妇进行队列研究，从她们童年首次患UTI开始随访，直至中位年龄41岁。临床数据来自产前和医院记录。通过（99m）锝-二巯基丁二酸扫描评估肾损伤。比较有和没有肾损伤的女性的妊娠血压（BP）、并发症和UTI情况。
所有女性均完成了调查，其中48名有肾损伤，24名无肾损伤。无论有无肾损伤，在首次妊娠前均无女性被诊断为高血压。151次妊娠中有10次诊断为妊娠相关高血压，均发生在有肾损伤的女性中。4名女性发生了先兆子痫。与无肾损伤的女性相比，有肾损伤的女性在首次妊娠最后一次产前检查时测得的收缩压显著更高（p = 0.005）。在随后的妊娠中，有肾损伤的女性的收缩压和舒张压均显著高于无肾损伤的女性（分别为p = 0.02和p = 0.03）。
在这项基于人群的随访研究中，我们发现很大一部分女性在童年患UTI后有肾损伤。与无肾损伤的女性相比，有肾损伤的女性在孕期血压显著更高。仅在有肾损伤的女性中记录到妊娠相关高血压。然而，包括先兆子痫在内的妊娠并发症很少。
