新生儿泌尿系统发育异常的影响因素及预后的临床追踪研究OACSTPCD

Objective To explore risk factors of congenital anomalies of the kidney and urinary tract(CAKUT)in newborns and to follow up prognosis of the disease.Methods A retrospective study was conducted.A total of 179 newborns with CAKUT who hospitalized in Department of Neonatology,Shenzhen Maternal and Child Health Hospital from January 2018 to May 2019 were selected.According to 1∶3 matching ratio,537 healthy newborns who gave birth in the same period in our hospital were as the control group.The risk factors of CAKUT were analyzed,and the diagnosis,treatment and prognosis of the infants were followed up according to classification of the disease type.Results The positive detection rate of CAKUT among the hospitalized newborns was 2.25% (179/7 956),including 123 cases of hydronephrosis.The proportions of primipara,preterm delivery,twin,male infant and small for gestational age(SGA)infant in the CAKUT group were higher(x2=17.939,11.575,8.633,14.257 and 9.647 respectively,all P＜0.05).Multivariate regression analysis showed that the risk of CAKUT was higher in the older primiparae than in the multiparae(OR=2.32,95% CI:1.08-4.98,P＜0.05).Compared with the full term infants,the risk of CAKUT was significantly higher in those premature infants(OR=1.94,95% CI:1.11-3.40,P＜0.05).The risk of CAKUT in the male infants was significantly higher than that in the female infants(OR=2.22,95% CI:1.51-3.27,P＜0.001).And the risk of CAKUT in the SGA infants was significantly higher than that in those appropriate for gestational age(AGA)infants(OR=2.18,95% CI:1.21-3.91,P＜0.05).The follow-up results showed that about 10% of the infants with CAKUT required surgical intervention,and more than 90% of the infants had good prognoses.Conclusion Premature delivery,SGA,male infant,and advanced maternal age are risk factors for CAKUT.Through timely treatment and follow-up,the most infants with CAKUT have good prognoses.