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Obstetrical outcome in women with urinary tract infections in childhood

Journal article
Authors Carin Gebäck
Sverker Hansson
Jeanette Martinell
Ian Milsom
Torsten Sandberg
Ulf Jodal
Published in Acta Obstetricia Et Gynecologica Scandinavica
Volume 95
Issue 4
Pages 452-457
ISSN 0001-6349
Publication year 2016
Published at Institute of Clinical Sciences, Department of Pediatrics
Institute of Biomedicine, Department of Infectious Medicine
Pages 452-457
Language en
Links dx.doi.org/10.1111/aogs.12853
Keywords Tc-99m-dimercaptosuccinic acid scan, follow up, hypertension, pregnancy, renal damage, urinary tract infection, vesicoureteral reflux, pregnancy, reflux, bacteriuria, pyelonephritis, hypertension, follow
Subject categories Clinical Medicine

Abstract

IntroductionUrinary 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. Material and methodsA 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 Tc-99m-dimercaptosuccinic acid scan. Pregnancy blood pressure (BP), complications and UTIs were compared between women with and without renal damage. ResultsAll 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). ConclusionIn 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.

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