Minna Honkila1,2, Annukka Hannula2, Tytti Pokka3,2, Anna-Maija Hanni4, Jarmo Salo3,2, Marjo Renko2,5, Marja Vääräsmäki2,6, Marja Perhomaa7, Elina Keskimäinen2, Matti Uhari3,2, Terhi Tapiainen3,2,8. 1. Departments of Pediatrics and Adolescent Medicine, minna.honkila@oulu.fi. 2. PEDEGO Research Unit and Medical Research Centre Oulu, University of Oulu, Oulu, Finland. 3. Departments of Pediatrics and Adolescent Medicine. 4. Health Care Centre, Oulu, Finland. 5. Department of Pediatrics, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; and. 6. Obstetrics and Gynecology, and. 7. Radiology, Oulu University Hospital, Oulu, Finland. 8. Biocenter Oulu, Oulu, Finland.
Abstract
BACKGROUND AND OBJECTIVES: Long-term outcomes of urinary tract infection (UTI) in childhood are not well known. Pregnancy may reveal latent renal damage caused by a UTI because of stress on the kidneys. METHODS: Our cohort included adult women with an ultrasonography taken because of a childhood UTI in 1981-1991 (N = 1175). Nine women with a severe congenital kidney malformation or urinary tract obstruction were excluded. Altogether, 260 mothers with a childhood UTI and 500 population-based control mothers without a childhood UTI matched for age, and delivery dates were compared. Our primary end point was the proportion of women with essential or gestational hypertension, preeclampsia, proteinuria, or pyelonephritis during the first pregnancy. RESULTS: The pregnancy outcomes of the women with a UTI in childhood did not differ from those of the controls because 105 of 260 (40%) patients met the primary end point compared with 204 of 500 (41%) controls (relative risk [RR] 0.99; 95% confidence interval [CI] 0.82 to 1.2; P = .91). Similarly, there were no significant differences between the 2 groups in essential hypertension (RR 1.0; 95% CI 0.65 to 1.6; P = .92), gestational hypertension (RR 0.93; 95% CI 0.74 to 1.2; P = .54), preeclampsia (RR 1.5; 95% CI 0.91 to 2.5; P = .11), proteinuria (RR 1.2; 95% CI 0.81 to 1.8; P = .36) or pyelonephritis (2 controls and none of the patients; P = .55) during the first pregnancy. CONCLUSIONS: Childhood UTIs did not increase the risk of pregnancy-related complications in this controlled population-based study. Thus, UTIs in childhood without severe urinary tract abnormalities appear to have a minimal effect on kidney health in early adulthood.
BACKGROUND AND OBJECTIVES: Long-term outcomes of urinary tract infection (UTI) in childhood are not well known. Pregnancy may reveal latent renal damage caused by a UTI because of stress on the kidneys. METHODS: Our cohort included adult women with an ultrasonography taken because of a childhood UTI in 1981-1991 (N = 1175). Nine women with a severe congenital kidney malformation or urinary tract obstruction were excluded. Altogether, 260 mothers with a childhood UTI and 500 population-based control mothers without a childhood UTI matched for age, and delivery dates were compared. Our primary end point was the proportion of women with essential or gestational hypertension, preeclampsia, proteinuria, or pyelonephritis during the first pregnancy. RESULTS: The pregnancy outcomes of the women with a UTI in childhood did not differ from those of the controls because 105 of 260 (40%) patients met the primary end point compared with 204 of 500 (41%) controls (relative risk [RR] 0.99; 95% confidence interval [CI] 0.82 to 1.2; P = .91). Similarly, there were no significant differences between the 2 groups in essential hypertension (RR 1.0; 95% CI 0.65 to 1.6; P = .92), gestational hypertension (RR 0.93; 95% CI 0.74 to 1.2; P = .54), preeclampsia (RR 1.5; 95% CI 0.91 to 2.5; P = .11), proteinuria (RR 1.2; 95% CI 0.81 to 1.8; P = .36) or pyelonephritis (2 controls and none of the patients; P = .55) during the first pregnancy. CONCLUSIONS: Childhood UTIs did not increase the risk of pregnancy-related complications in this controlled population-based study. Thus, UTIs in childhood without severe urinary tract abnormalities appear to have a minimal effect on kidney health in early adulthood.