Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
Ital J Pediatr. 2019 Apr 18;45(1):50. doi: 10.1186/s13052-019-0635-9.
Congenital anomalies of the kidney and urinary tract (CAKUTs) are some of the most common birth defects affecting newborns. CAKUTs often have poor birth outcomes owing to the limited experience of physicians in developing countries regarding antenatal and postnatal diagnosis. We aimed to estimate the epidemiology of CAKUTs using data from a hospital-based registry in Zhejiang Province, China.
We included a total of 2790 newborns with CAKUTs, identified among 1,748,038 births during 2010-2016. The prevalence and type of CAKUTs, maternal and neonatal characteristics, and associated malformations were analyzed.
The average prevalence of CAKUTs born to mothers overall and mothers aged ≥35 years were both around 1.60 per 1000 births (95% confidence interval (CI), 1.54-1.66; 95% CI, 1.44-1.83, respectively) during the study period. The prevalence of CAKUTs changed over time among all women and women of advanced maternal age, although no significant trends were observed. CAKUTs were more likely to occur in male than female newborns (odds ratio (OR) 1.28, 95% CI 1.18-1.38), in multiple births than singletons (OR 1.53, 95% CI 1.21-1.92) and in urban areas than rural areas (OR 1.27, 95% CI 1.18-1.37). The overall prenatal detection rate of CAKUTs was 73.87%. The average gestational age at antenatal diagnosis was 26.57 ± 8.70 weeks. A total 22.69% CAKUTs had associated malformations. Congenital heart defects were the most common anomalies, accounting for 8.89% of the whole population. The main proportion in subgroups was hydronephrosis, representing 31.79% of registered CAKUTs.
There was a nearly twofold increase in the prevalence of CAKUTs from 2010 to 2016 in Zhejiang Province. CAKUTs are strongly associated with male sex, multiple births, urban areas, and other nonurinary congenital malformations.
先天性肾和尿路畸形（CAKUT）是影响新生儿的最常见出生缺陷之一。由于发展中国家医生在产前和产后诊断方面经验有限，CAKUT 常导致不良的出生结局。我们旨在使用中国浙江省医院登记处的数据来估计 CAKUT 的流行病学。
我们纳入了 2010 年至 2016 年期间 1748038 例分娩中发现的 2790 例 CAKUT 新生儿。分析了 CAKUT 的患病率和类型、产妇和新生儿特征以及相关畸形。
总体而言，CAKUT 患儿母亲的平均患病率和 35 岁以上母亲的平均患病率均约为每 1000 例活产 1.60 例（95%置信区间（CI），1.54-1.66；95%CI，1.44-1.83）。在整个研究期间，所有女性和高龄产妇的 CAKUT 患病率均随时间而变化，尽管未观察到明显的趋势。CAKUT 在男性新生儿中比女性新生儿更常见（比值比（OR）1.28，95%CI 1.18-1.38），在多胎妊娠中比单胎妊娠更常见（OR 1.53，95%CI 1.21-1.92），在城市地区比农村地区更常见（OR 1.27，95%CI 1.18-1.37）。CAKUT 的总体产前检出率为 73.87%。产前诊断的平均孕周为 26.57±8.70 周。共有 22.69%的 CAKUT 有相关畸形。先天性心脏病是最常见的畸形，占总人群的 8.89%。各亚组的主要比例为肾积水，占登记 CAKUT 的 31.79%。
浙江省 2010 年至 2016 年 CAKUT 的患病率几乎翻了一番。CAKUT 与男性、多胎妊娠、城市地区和其他非泌尿系统先天性畸形密切相关。
