Abstract:
BACKGROUND : Congenital anomalies of the kidney and the urinary tract (CAKUTs) are relatively common birth
defects. The combined prevalence in Europe was 3.3 per 1000 in 2012. The risk factors for these
anomalies are not clearly identified. The aims of our study were to calculate the birth
prevalences of urinary malformations in Murmansk County during 2006-2011 and to investigate
related prenatal risk factors.
METHODS : The Murmansk County Birth Registry was the primary source of information and our study
included 50 936 singletons in the examination of structure, prevalence and proportional
distribution of CAKUTs. The multivariate analyses of risk factors involved 39 322 newborns.
RESULTS : The prevalence of CAKUTs was 4.0 per 1000 newborns [95%CI: 3.4-4.5] and did not change
during the study period. The most prevalent malformation was congenital hydronephrosis
(14.2% of all cases). Diabetes mellitus or gestational diabetes [OR = 4.77, 95%CI: 1.16-19.65],
acute infections while pregnant [OR = 1.83, 95%CI: 1.14-2.94], the use of medication during
pregnancy [OR = 2.03, 95%CI: 1.44-2.82], and conception during the summer [OR = 1.75,
95%CI 1.15-2.66] were significantly associated with higher risk of CAKUTs.
CONCLUSIONS : The overall four-fold enhancement of the occurrence of urinary malformations in Murmansk
County for the 2006-2011 period showed little annual dependence. During pregnancy, use of
medications, infections, pre-existing diabetes mellitus or gestational diabetes were associated
with increased risk of these anomalies, as was conception during summer. Our findings have
direct applications in improving prenatal care in Murmansk County and establishing targets for
prenatal screening and women’s consultations.