title: Systematic review of accuracy of fetal urine analysis to predict poor postnatal renal function in cases of congenital urinary tract obstruction.
abstract: OBJECTIVE
  To evaluate the clinical usefulness of analysis of fetal urine in the prediction of poor postnatal renal function in cases of congenital urinary tract obstruction.
  
  
  METHODS
  A systematic review was performed. We conducted extensive electronic searches (database inception-2006). The reference lists of articles obtained were searched for any further articles. Two reviewers independently selected the articles in which the accuracy of fetal urinalysis was evaluated to predict poor postnatal renal function. There were no language restrictions. Data were extracted on study characteristics, quality and results, to construct 2 x 2 tables. Likelihood ratios for positive (LR+) and negative (LR-) test results were generated for the different fetal urinary analytes at various thresholds.
  
  
  RESULTS
  There were 23 articles that met the selection criteria, including a total of 572 women and 63 2 x 2 tables. The two most accurate tests were calcium > 95th centile for gestation (LR + 6.65, 0.23-190.96; LR - 0.19, 0.05-0.74) and sodium > 95th centile for gestation (LR + 4.46, 1.71-11.6; LR - 0.39, 0.17-0.88). beta(2)-microglobulin was found to be less accurate (LR + 2.92, 1.28-6.69; LR - 0.53, 0.24-1.17).
  
  
  CONCLUSIONS
  The current evidence demonstrates that none of the analytes of fetal urine investigated so far can be shown to yield clinically significant accuracy to predict poor postnatal renal function.
authors.affiliation: Division of Reproductive and Child Health, Birmingham Women's Hospital, University of Birmingham, Birmingham, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Morris
authors.forename: E
authors.initials: E
authors.lastname: Quinlan-Jones
authors.forename: M D
authors.initials: MD
authors.lastname: Kilby
authors.forename: K S
authors.initials: KS
authors.lastname: Khan
mesh_terms: D016208:Databases, Factual; D005260:Female; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D014524:Urethral Obstruction / Q000151:congenital / Q000175:diagnosis* / Q000652:urine; D016482:Urinalysis / Q000379:methods*