| ObjectiveUltrasound screening was performed in the high-risk newborns in some areas of Ningbo to understand the incidence rate of the congenital anomalies of the kidney and urinary tract (CAKUT) and the proportion of various malformations to support the clinical diagnosis and treatment and prognosis.MethodsWe selected Ninghai Region and Fenghua Region as the screening regions by random sampling method, and selected all of the high-risk newborns who were born between 2013.1.1-2013.12.31 for ultrasound screening objects. We counted the numbers of every congenital malformation of the urinary system and analyzing the relation between those with malformation in urinary systems and their maternal risk factors (premature baby, low birth weight infant, caesarean section, pathological jaundice, fetal distress, intrauterine infection, etc).In the meanwhile, the neonates with problem were followed up to observe the prognosis, the growth and development in the later two years.Result1. A total of 3385 cases of high risk infants, and parents agreed to ultrasound screening of children with 2742 cases, screening rate was 81%,155 neonates had been diagnosed with congenital anomalies of the kidney and urinary tract, the incidence rate was 5.65%. boys 108 cases, the incidence rate was 6.62%; girls 47 cases, the incidence rate was 4.23%.There had statistical difference in incidence rate between boys and girls (X2=7.085,P<0.05).2. In our research, different classifications include:147 cases with positive reaction in hydronephrosis, while 2 in agenesis of kidney,1 in renal hypoplasia,3 in Cystic kidney disease, and 2 in Ectopic kidney as well. Hydronephrosis was the most common seen symptom in the abnormalities of genitourinary system.3. According to the gravid’s residence, we put them into urban and country-side. There were 66 children with congenital anomalies of the kidney and urinary tract from the 1586 cases in urban, which incidence rate was 4.16%,there were 89 children with congenital anomalies of the kidney and urinary tract from the 1156 cases in countryside, which incidence rate was 7.70%. The incidence rate of congenital anomalies of the kidney and urinary tract in countryside was higher than that in urban. It had statistically significant(X2= 15.689, P<0.05).4. Seasonal distribution, the incidence of congenital anomalies of the kidney and urinary tract of the children whose mother was pregnancy in spring was 5.22%, the incidence of congenital anomalies of the kidney and urinary tract of the children whose mother was pregnancy in summer was 6.05%, the incidence of congenital anomalies of the kidney and urinary tract of the children whose mother was pregnancy in autumn was 4.73%, the incidence of congenital anomalies of the kidney and urinary tract of the children whose mother was pregnancy in winter was 6.53%, the incidence of congenital anomalies of the kidney and urinary tract of the children whose mother was pregnancy in the four seasons had no statistically significant (x2= 2.508, P> 0.05).5. In this high-risk newborn screening urinary system, the main risk factors present in children with low birth weight, premature, jaundice, neonatal asphyxia and cesarean section; other risk factors include old age pregnancy, younger age pregnancy, macrosomia, multiple pregnancy, associated with other malformations, etc.6.147 cases of children with congenital hydronephrosis were followed.142 cases with renal pelvis separation degree below 15mm.In the follow-up,12 cases have been lost,126 cases could naturally healed without any special treatment, the remaining 4 cases did not improve.5 kidneys with renal pelvis separation degree above 15mm,3 cases have been followed up with a result of worse prognosis.7. To assess their growth and development by the height, BMI (Body Mass Index, BMI), compared CAKUT group and the healthy control group in height, the height difference was not statistically significant (x2=3.499, P> 0.05), compared CAKUT group and the healthy control group in BMI, the difference of body mass index was not statistically significant (x2= 2.836, P> 0.05). Conclusion1. There were 5.65% neonates that have been diagnosed with congenital anomalies of the kidney and urinary tract in this ultrasound screening for urinary system to those who are considered to be high-risked. Hydronephrosis was the most common seen case of the congenital anomalies of the kidney and urinary tract, and most of hydronephrosis following a result of well prognosis.2.In the children with congenital anomalies of the kidney and urinary tract, male was more than female; countryside was more than urban.3. The incidence of congenital anomalies of the kidney and urinary tract of neonates whose mother was pregnancy in different seasons have no statistically significant.4. Common high risk factors related to the neonates who have congenital anomalies of the kidney and urinary tract maybe include:premature baby, low birth weight infant, caesarean section, etc.5. The children with CAKUT had a well prognosis in the growth and develop-ment. |
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