Maternal obesity is associated with congenital anomalies of the kidney and urinary tract in offspring

Abstract

Our results demonstrate a positive association between maternal obesity and CAKUT in offspring, as well as between obesity severity and the odds of CAKUT in offspring. These findings provide additional evidence for the public health importance of obesity, particularly as a potentially modifiable risk factor.

Prenatal diagnosis of urinary tract anomalies, a cohort study in the Northern Netherlands

“…There is a significant variation in prevalence of UT anomalies among (European) regions, with prevalence rates ranging between 12 and 71 per 10 000 births. Several nongenetic risk factors, such as maternal diabetes, obesity, and subfertility, have been identified that may explain in part the variations and trends that are observed in prevalence of (specific types of) UT anomalies. It remains unclear whether folic acid has a protective effect or increases the risk for (specific) urinary tract anomalies.…”

“…Some anomalies are incompatible with life, such as bilateral renal agenesis, while other anomalies are mild and may remain undetected if not diagnosed by ultrasound. Risk factors for UT anomalies include genetic and nongenetic factors, such as maternal obesity and fertility treatment, whereas the use of folic acid is reported to reduce the risk . Urinary tract anomalies are more commonly observed in male fetuses .…”

Clinical Integration of Genome Diagnostics for Congenital Anomalies of the Kidney and Urinary Tract

“…One striking example of fetal programming is the robust association between low birth weight, a proxy for intrauterine environmental circumstances, and a reduced nephron number (68). Other well described environmental hazards in the etiology of CAKUT are maternal obesity and maternal diabetes (69)(70)(71). Because nephrogenesis takes place until the 34th-36th gestational week, clinicians should specifically be cautious not to prescribe medications that disturb kidney and urinary tract development in pregnant women and prematurely born infants (72,73).…”

Genetic basis of human congenital anomalies of the kidney and urinary tract

“…Studies have shown that different structural defects have distinct impacts on long-term renal survival and overall mortality, with RHD conferring the greatest risk of adverse events (26)(27)(28)(29)(30). A number of extrinsic factors including maternal diabetes, medications, and folate and iron deficiency also increase the risk of CAKUT, highlighting environmental factors that modify expression of disease (31,32). When ESRD is present at birth, mortality rates reach a striking 93% within the first year of life (33), and children who survive infancy have a 30-fold higher mortality compared with same-age children without ESRD (34).…”