title: Guidelines for urinary tract infections and antenatal hydronephrosis should be gender specific.
abstract: OBJECTIVE
  Febrile urinary tract infections (UTIs) may be associated with long-term renal damage. Our goal was to identify risk factors for future UTIs in children who had voiding cystourethrography (VCUG) as a part of an antenatal hydronephrosis (ANH) assessment or after a febrile UTI.
  
  
  METHODS
  We conducted a cohort study based on the medical records of children aged 0-24 months who underwent a VCUG between January 2004 and December 2011 and had at least six months of follow-up. The incidence of future UTIs was assessed.
  
  
  RESULTS
  We included 285 children: 176 had a primary UTI and 109 had ANH. We recorded 28 UTIs during the follow-up period, and the risk was 12.5% after a primary UTI and 5.5% after an ANH (p = 0.049). Multivariate analysis showed no risk difference was found between the groups. Females had a greater risk of febrile UTIs (hazard ratio 3.3, 95% confidence interval 1.03-9.2, p = 0.04), but the UTI risk did not differ between children with or without VURs.
  
  
  CONCLUSIONS
  Female infants were at greater risk of febrile UTIs, regardless of the presence of VUR, VUR degree, ANH or a previous UTI. Clinical guidelines for UTI and ANH assessment should preferably be gender specific.
authors.affiliation: Department of Paediatrics, Meir Medical Centre, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shiran S
authors.initials: SS
authors.lastname: Moore
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Paediatrics, Assaf Harofeh Medical Centre, Zerifin, Israel.
authors.forename: Hilla
authors.initials: H
authors.lastname: Bahat
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Paediatrics, Assaf Harofeh Medical Centre, Zerifin, Israel.
authors.forename: Mariana
authors.initials: M
authors.lastname: Rachmiel
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tomer
authors.initials: T
authors.lastname: Ziv-Baran
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Paediatrics, Assaf Harofeh Medical Centre, Zerifin, Israel.
authors.forename: Ilan
authors.identifier: http://orcid.org/0000-0001-5233-1213
authors.initials: I
authors.lastname: Youngster
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Paediatrics, Assaf Harofeh Medical Centre, Zerifin, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Goldman
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005315:Fetal Diseases; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012737:Sex Factors; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*
keywords: Antenatal hydronephrosis; Renal scaring; Urinary tract infection; Vesicoureteral reflux; Voiding cystourethrography