Kuok Chon In, Hsu Mei Lam Natalie, Lam Hiu Ching, Chung Wai Hung, Ho Wing Tung Natalie, Kung Choi Kim Judy, Wong Kin Nam Karen, Lai Stephanie Hui Fung, Ma Wei Ling Teresa, Siu Kiu Lok, Chan Winnie Kwai Yu
Department of Pediatrics, Queen Elizabeth Hospital, Hong Kong, HKG.
Department of Obstetrics and Gynecology, Queen Elizabeth Hospital, Hong Kong, HKG.
Cureus. 2024 Oct 5;16(10):e70876. doi: 10.7759/cureus.70876. eCollection 2024 Oct.
Background Our study aims to evaluate the characteristics of congenital anomalies of kidneys and urinary tracts (CAKUT) and urinary tract infection (UTI) in babies with single umbilical artery (SUA) and to identify factors associated with these outcomes. Methods We performed a 15-year retrospective analysis on babies who were born ≥34 weeks with SUA between 2006 and 2020. Relevant clinical information on obstetrics and neonatal examinations, UTIs, and imaging of the urinary systems was evaluated. Results The frequency of SUA in newborns was 3.28 per 1,000 deliveries. The majority (271/291; 93.1%) of patients had kidney ultrasound, and 19 (7.0%) had CAKUT. Hydronephrosis (n = 11, 57.9%) was the commonest CAKUT, followed by unilateral kidney agenesis (n = 3, 15.8%), horseshoe kidney (n = 2, 10.5%), and right low-lying kidney (n = 2, 10.5%). Most significant CAKUT (including solitary kidney and urinary tract obstruction) could be detected during the antenatal period. Congenital heart defect (OR 4.93, 95% CI 1.59-15.34), limbs (OR 9.77, 95% CI 1.53-62.44), and sacral abnormalities (OR 5.06, 95% CI 1.25-20.55) were associated with CAKUT. Six (2.1%) developed UTIs during the study period, with the majority below two years old. The presence of CAKUT was associated with the development of UTI after adjustment (adjusted HR 10.28, 95% CI 1.86-56.83). Conclusions The overall prevalence of CAKUT was 7.0% in patients with SUA, and the majority of significant CAKUT was identified during the antenatal period. Congenital heart defects, limbs, and sacral abnormalities were associated with CAKUT. UTI occurred in 2.1% of patients.
背景 我们的研究旨在评估单脐动脉（SUA）婴儿的先天性肾脏和尿路畸形（CAKUT）及尿路感染（UTI）的特征，并确定与这些结局相关的因素。方法 我们对2006年至2020年间出生孕周≥34周且患有SUA的婴儿进行了一项为期15年的回顾性分析。评估了有关产科和新生儿检查、UTI以及泌尿系统影像学的相关临床信息。结果 新生儿中SUA的发生率为每1000例分娩中有3.28例。大多数患者（271/291；93.1%）接受了肾脏超声检查，19例（7.0%）患有CAKUT。肾盂积水（n = 11，57.9%）是最常见的CAKUT，其次是单侧肾缺如（n = 3，15.8%）、马蹄肾（n = 2，10.5%）和右低位肾（n = 2，10.5%）。大多数严重的CAKUT（包括孤立肾和尿路梗阻）可在产前检测到。先天性心脏病（OR 4.93，95%CI 1.59 - 15.34）、肢体（OR 9.77，95%CI 1.53 - 62.44）和骶骨异常（OR 5.06，95%CI 1.25 - 20.55）与CAKUT相关。在研究期间，6例（2.1%）发生了UTI，大多数年龄在2岁以下。调整后，CAKUT的存在与UTI的发生相关（调整后HR 10.28，95%CI 1.86 - 56.83）。结论 SUA患者中CAKUT的总体患病率为7.0%，大多数严重的CAKUT在产前被发现。先天性心脏病、肢体和骶骨异常与CAKUT相关。2.1%的患者发生了UTI。
