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Frequency of Confirmed Congenital Renal Malformations in Neonates with Antenatal Diagnosis of Renal Anomalies Presenting in Neonatal Intensive Care Unit of a Tertiary Care Setting of a Low Income Country

Author(s): Qurat-Ul-Ain Siddique, Abid Ali Jamali, Sanober Fatima, Jai Parkash

Introduction: Approximately 20 to 30% of all anomalies identified in the prenatal period are congenital anomalies of the kidney and urinary tract (CAKUT). Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. There are limited studies on the postnatal confirmation of these antenatally detected renal malformations. Moreover, there is no local data available in this regard. So, we conducted the study so that we can obtain local data as well as we can plan management and prevention protocols for such chronically, and sometimes critically, ill neonates.

Materials and Methods: It was a cross-sectional study conducted at the neonatal intensive care unit (NICU) at the National Institute of Child Health, Karachi during 2017-2018. The sample size was 100 cases. The sampling technique was non-probability consecutive sampling. All neonates aged 1-28 days of either gender admitted in NICU with antenatal diagnosis of congenital renal anomalies on anomaly scan were included in the study. Preterm neonates (gestational age below 34 weeks) and neonates having siblings with similar congenital problems were excluded.

Results: The mean age of the neonates in our study was 10.17 ± 9.30 days and the mean gestational age at birth was 36.65 ± 1.16 weeks. The majority of the neonates, that is 65%, were males while 35% were females. Sixty-six per cent (66%) neonates were ≤10 days of age while 34% were >10 days of age. Fifty five% of the neonates were ≤36 weeks of gestation at birth while 45% were >36 weeks of gestation at birth. Frequency of postnatally confirmed congenital renal malformation was observed in 78 (78%) neonates. Neonates whose age at presentation was >10 days were slightly more likely to have confirmed congenital renal malformation as compared to neonates with ≤10 days of age, which is 85.3 % vs 74.2 % (p-value 0.206). Males and females were found to have almost equal postnatally confirmed congenital renal malformations (78.5 % in males and 77.1% in females) (p-value 0.879). Postnatally confirmed congenital renal malformations were observed more commonly in neonates who were >36 weeks of gestational age (80%) as compared to those ≤36 weeks of gestational age (76.4%) (p-value 0.662).

Conclusion: The frequency of confirmed congenital renal malformation was found higher in neonates presenting with antenatal diagnosis of renal anomalies presenting in the neonatal intensive care unit.

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