title: Obstetrical outcome in women with urinary tract infections in childhood.
abstract: BACKGROUND
  Urinary 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.
  
  
  METHODS
  A 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 (99m) Tc-dimercaptosuccinic acid scan. Pregnancy blood pressure (BP), complications and UTIs were compared between women with and without renal damage.
  
  
  RESULTS
  All 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).
  
  
  CONCLUSIONS
  In 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.
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Gothenburg, Sweden.|Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Carin
authors.identifier: http://orcid.org/0000-0002-3883-9165
authors.initials: C
authors.lastname: Gebäck
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Gothenburg, Sweden.
authors.forename: Sverker
authors.identifier: http://orcid.org/0000-0002-5047-2968
authors.initials: S
authors.lastname: Hansson
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Gothenburg, Sweden.
authors.forename: Jeanette
authors.identifier: http://orcid.org/0000-0003-0635-0530
authors.initials: J
authors.lastname: Martinell
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Gothenburg, Sweden.
authors.forename: Ian
authors.identifier: http://orcid.org/0000-0002-9435-1957
authors.initials: I
authors.lastname: Milsom
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Torsten
authors.identifier: http://orcid.org/0000-0001-5364-6743
authors.initials: T
authors.lastname: Sandberg
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Gothenburg, Sweden.
authors.forename: Ulf
authors.identifier: http://orcid.org/0000-0002-0400-5509
authors.initials: U
authors.lastname: Jodal
mesh_terms: D000328:Adult; D002921:Cicatrix; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007668:Kidney / Q000473:pathology*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011866:Radioisotope Renography; D012307:Risk Factors; D013997:Time Factors; D014552:Urinary Tract Infections / Q000150:complications / Q000473:pathology*
keywords: 99mTc-dimercaptosuccinic acid scan; follow up; hypertension; pregnancy; renal damage; urinary tract infection; vesicoureteral reflux