Pregnancies in women with childhood vesicoureteral reflux.
OBJECTIVE
The frequency of pregnancy complications together with renal scarring and voiding dysfunction-related risk factors were investigated in a cohort of women with a history of childhood vesicoureteral reflux (VUR).


METHODS
A retrospective cross-sectional cohort study.


METHODS
Eighty-seven primi- or multiparous middle-aged women diagnosed with primary non-obstructive VUR in childhood.


METHODS
Pregnancy outcome was assessed from case records and from patient interviews. Urine flow tests for voiding patterns, renal ultrasound for detecting scars, and blood samples for renal function were investigated. The median follow-up time was 38 years.


METHODS
Prevalence of pregnancy complications in women with childhood VUR in relation to renal scars and voiding abnormalities.


RESULTS
Maternal complications were seen in 64% of the women and fetal complications in 13%. The women with renal scars (48/87) more often had hypertension (33%), proteinuria (40%) and urinary tract infections (42%) during pregnancy than women without scarring. The frequency of fetal complications was not increased by renal scarring or proteinuria during pregnancy. Urinary tract infections during pregnancy (33% of the women) and voiding abnormalities (18%) did not increase the frequency of fetal or maternal complications. The women with fetal complications were more predisposed to frequent urinary tract infections during adult life (55%) than were those without fetal complications (24%) (p = 0.04).


CONCLUSIONS
The maternal complication rates in women with childhood VUR were increased only by renal scarring. Frequent urinary tract infections during adulthood seemed to predict an elevated risk of fetal complications.
Department of Pediatric Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
Hanna-Mari
HM
Roihuvuo-Leskinen
Department of Obstetrics and Gynecology, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
Merja I
MI
Vainio
Department of Radiology, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Kaija M
KM
Niskanen
Department of Pediatric Surgery, Tampere University Hospital, Tampere, Finland.
Tuija T
TT
Lahdes-Vasama
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000473:pathology; D011256:Pregnancy Outcome; D011507:Proteinuria / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000473:pathology; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000473:pathology; D055815:Young Adult
Fetal complications; long-term outcome; medical and surgical complications of pregnancy; renal scars; uroflow; vesico-ureteral reflux