TY - JOUR
T1 - Maternal Chronic Disease and Congenital Anomalies of the Kidney and Urinary Tract in Offspring
T2 - A Japanese Cohort Study
AU - The Japan Environment and Children’s Study Group
AU - Nishiyama, Kei
AU - Sanefuji, Masafumi
AU - Kurokawa, Mari
AU - Iwaya, Yuka
AU - Hamada, Norio
AU - Sonoda, Yuri
AU - Ogawa, Masanobu
AU - Shimono, Masayuki
AU - Suga, Reiko
AU - Kusuhara, Koichi
AU - Ohga, Shouichi
AU - Kamijima, Michihiro
AU - Yamazaki, Shin
AU - Ohya, Yukihiro
AU - Kishi, Reiko
AU - Yaegashi, Nobuo
AU - Hashimoto, Koichi
AU - Mori, Chisato
AU - Ito, Shuichi
AU - Yamagata, Zentaro
AU - Inadera, Hidekuni
AU - Nakayama, Takeo
AU - Iso, Hiroyasu
AU - Shima, Masayuki
AU - Nakamura, Hiroshige
AU - Suganuma, Narufumi
AU - Katoh, Takahiko
N1 - Funding Information:
Michihiro Kamijima (principal investigator; Nagoya City University, Nagoya, Japan), Shin Yamazaki (National Institute for Environmental Studies, Tsukuba, Japan), Yukihiro Ohya (National Center for Child Health and Development, Tokyo, Japan), Reiko Kishi (Hokkaido University, Sapporo, Japan), Nobuo Yaegashi (Tohoku University, Sendai, Japan), Koichi Hashimoto (Fukushima Medical University, Fukushima, Japan), Chisato Mori (Chiba University, Chiba, Japan), Shuichi Ito (Yokohama City University, Yokohama, Japan), Zentaro Yamagata (University of Yamanashi, Chuo, Japan), Hidekuni Inadera (University of Toyama, Toyama, Japan), Takeo Nakayama (Kyoto University, Kyoto, Japan), Hiroyasu Iso (Osaka University, Suita, Japan), Masayuki Shima (Hyogo College of Medicine, Nishinomiya, Japan), Hiroshige Nakamura (Tottori University, Yonago, Japan), Narufumi Suganuma (Kochi University, Nankoku, Japan), and Takahiko Katoh (Kumamoto University, Kumamoto, Japan). Kei Nishiyama, MD, Masafumi Sanefuji, MD, PhD, Mari Kurokawa, MD, Yuka Iwaya, MD, Norio Hamada, MD, PhD, Yuri Sonoda, MD, Masanobu Ogawa, MD, PhD, Masayuki Shimono, MD, PhD, Reiko Suga, BA, Koichi Kusuhara, MD, PhD, and Shouichi Ohga, MD, PhD. The members of the JECS Group are as of 2022, and also include author KK. Conceived study: KN; designed study: MSanefuji; collected data: MSanefuji, YS, MO, MShimono, RS; analyzed data: KN, MSanefuji; interpreted the results: KN, MSanefuji, MK, YI, NH; supervised study: KK, SO. Each author contributed important intellectual content during manuscript drafting or revision and agrees to be personally accountable for the individual's own contributions and to ensure that questions pertaining to the accuracy or integrity of any portion of the work, even one in which the author was not directly involved, are appropriately investigated and resolved, including with documentation in the literature if appropriate. The JECS and the present study were funded by the Ministry of the Environment, Japan. The funder had a role in the study design and data collection but no role in the analysis, reporting, or decision to submit the manuscript for publication. The authors declare that they have no relevant financial interests. We thank all participants of the JECS and all staff members involved in data collection. The findings and conclusions of this article are the sole responsibility of the authors and do not represent the official views of the Japanese government. Received September 8, 2021. Evaluated by 2 external peer reviewers, with direct editorial input from a Statistics/Methods Editor, an Associate Editor, and the Editor-in-Chief. Accepted in revised form March 1, 2022.
Funding Information:
The JECS and the present study were funded by the Ministry of the Environment, Japan. The funder had a role in the study design and data collection but no role in the analysis, reporting, or decision to submit the manuscript for publication.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - Rationale & Objective: Several maternal chronic diseases have been reported as risk factors for congenital anomalies of the kidney and urinary tract (CAKUT) in offspring. However, these investigations used case-control designs, and cases with isolated genitourinary CAKUT were not distinguished from cases in which CAKUT were present with extrarenal congenital anomalies (complicated CAKUT). We examined the association of maternal diseases with isolated and complicated CAKUT in offspring using data from a prospective cohort study. Study Design: A nationwide prospective birth cohort study. Setting & Participants: 100,239 children enrolled in the Japan Environment and Children's Study between January 2011 and March 2014 at 15 research centers. Physicians’ diagnoses in mothers and children were collected from medical record transcripts and questionnaires. Exposures: Medical histories of maternal noncommunicable diseases, including obesity, hypertension, diabetes mellitus, kidney disease, hyperthyroidism, hypothyroidism, psychiatric disease, epilepsy, cancer, and autoimmune disease. Outcomes: CAKUT diagnosed during the first 3 years of life, classified as isolated or complicated. Analytical Approach: Multivariable Poisson regression with generalized estimating equations accounting for clustering by clinical center. Results: Among the 100,239 children, 560 (0.6%) had CAKUT, comprising 454 (81%) isolated and 106 (19%) complicated forms. The risk of isolated CAKUT was increased in children of mothers who experienced kidney disease (adjusted risk ratio [RR], 1.80 [95% CI, 1.12-2.91]) or cancer (RR, 2.11 [95% CI, 1.15-3.86]). Furthermore, the risk of complicated CAKUT was increased in children of mothers with diabetes mellitus (RR, 3.04 [95% CI, 1.64-5.61]). Limitations: Lack of standardization or prespecification of clinical definitions, diagnostic criteria, measurements, and testing. Genetic testing was not performed. Conclusions: Isolated CAKUTs and complicated CAKUTs were associated with different maternal diseases. The results may inform clinical management of pregnancy and highlight potential differences in the genesis of isolated and complicated forms of CAKUT.
AB - Rationale & Objective: Several maternal chronic diseases have been reported as risk factors for congenital anomalies of the kidney and urinary tract (CAKUT) in offspring. However, these investigations used case-control designs, and cases with isolated genitourinary CAKUT were not distinguished from cases in which CAKUT were present with extrarenal congenital anomalies (complicated CAKUT). We examined the association of maternal diseases with isolated and complicated CAKUT in offspring using data from a prospective cohort study. Study Design: A nationwide prospective birth cohort study. Setting & Participants: 100,239 children enrolled in the Japan Environment and Children's Study between January 2011 and March 2014 at 15 research centers. Physicians’ diagnoses in mothers and children were collected from medical record transcripts and questionnaires. Exposures: Medical histories of maternal noncommunicable diseases, including obesity, hypertension, diabetes mellitus, kidney disease, hyperthyroidism, hypothyroidism, psychiatric disease, epilepsy, cancer, and autoimmune disease. Outcomes: CAKUT diagnosed during the first 3 years of life, classified as isolated or complicated. Analytical Approach: Multivariable Poisson regression with generalized estimating equations accounting for clustering by clinical center. Results: Among the 100,239 children, 560 (0.6%) had CAKUT, comprising 454 (81%) isolated and 106 (19%) complicated forms. The risk of isolated CAKUT was increased in children of mothers who experienced kidney disease (adjusted risk ratio [RR], 1.80 [95% CI, 1.12-2.91]) or cancer (RR, 2.11 [95% CI, 1.15-3.86]). Furthermore, the risk of complicated CAKUT was increased in children of mothers with diabetes mellitus (RR, 3.04 [95% CI, 1.64-5.61]). Limitations: Lack of standardization or prespecification of clinical definitions, diagnostic criteria, measurements, and testing. Genetic testing was not performed. Conclusions: Isolated CAKUTs and complicated CAKUTs were associated with different maternal diseases. The results may inform clinical management of pregnancy and highlight potential differences in the genesis of isolated and complicated forms of CAKUT.
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U2 - 10.1053/j.ajkd.2022.03.003
DO - 10.1053/j.ajkd.2022.03.003
M3 - Article
C2 - 35439592
AN - SCOPUS:85133325275
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
ER -
