Results of a retrospective analysis to identify the causes of nephropathologies in prenatal children exposed to maternal inflammatory process of bacterial etiology of the genitourinary system

Yurii  Mishyn; Mykhailo Myroshnychenko; Maryna  Mishyna; Alessandra  Marchese; Roberta  Pisi; Olha Bondarenko; Marina  Aiello; Alfredo Chetta

doi:10.23750/abm.v96i6.17243

Results of a retrospective analysis to identify the causes of nephropathologies in prenatal children exposed to maternal inflammatory process of bacterial etiology of the genitourinary system

Authors

Yurii Mishyn Department of General and Clinical Pathological Physiology named after D.O. Alpern, Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0003-2226-2944
Mykhailo Myroshnychenko Department of General and Clinical Pathological Physiology named after D.O. Alpern, Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0002-6920-8374
Maryna Mishyna Department of Microbiology, Virology and Immunology named after D.P. Grynyov, Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0001-6484-4198
Alessandra Marchese Department of Medicine and Surgery, University of Parma, Parma, Italy https://orcid.org/0009-0004-2341-8458
Roberta Pisi Department of Medicine and Surgery, University of Parma, Parma, Italy https://orcid.org/0000-0001-5552-2912
Olha Bondarenko Department of Microbiology, Virology and Immunology named after D.P. Grynyov, Kharkiv National Medical University, Kharkiv, Ukraine; Department of Medicine and Surgery, University of Parma, Parma, Italy https://orcid.org/0000-0002-4808-9513
Marina Aiello Department of Medicine and Surgery, University of Parma, Parma, Italy https://orcid.org/0000-0003-0636-5345
Alfredo Chetta Department of Medicine and Surgery, University of Parma, Parma, Italy https://orcid.org/0000-0002-0416-5334

Keywords:

nephropathology, children, inflammatory process, genitourinary system, bacterial factors

Abstract

Background and Aim. Urinary tract infection during pregnancy is one of the most common infections in women. Nearly two-thirds of babies are born with kidney disease due to prenatal exposure to inflammation in the mother. Determining the risk of developing kidney disease is important to prevent complications. The aim of this study is to determine the causes and criteria for the occurrence of specific manifestations of nephropathology in children of different ages and genders, based on a retrospective analysis of archival documentation.

Methods. Retrospective cohort study included archival documentation of 76 cases of kidney diseases in children of various ages born to mothers whose pregnancies occured against the background of inflammatory diseases of the genitourinary system of bacterial etiology.

Results. The occurence of kidney diseases in children depends on age and gender. Kidney diseases were detected in girls of the older age group in 67.1% of cases. The debut of nephropathy from birth was detected in 28.4 % of cases. Manifest kidney diseases at an early age was detected in 23.7% of cases. In 93.4% of cases combined kidney pathologies were registered.

Conclusion. The frequency of nephropathology in children of different ages is associated with the presence of an infectious process of the genitourinary system of bacterial etiology in women during pregnancy. The early risk of nephropathology in children is associated with an infectious disease of the genitourinary system of the mother during pregnancy. The manifestation of inflammation in the presence of a complex perinatal history occurs at birth or in early childhood.

References

1. Abdel-Aziz Elzayat M, Banett-Vanes A, Dabour MFE, Cheng F. Prevalence of undiagnosed asymptomatic bacteriuria and associated risk factors during pregnancy: a cross-sectional study at two tertiary centres in Cairo, Egypt. BMJ Open. 2017;7:e013198. doi:10.1136/bmjopen-2016-013198.

2. Mera-Lojano LD, Mejía-Contreras LA, Cajas-Velásquez SM, Guarderas-Muñoz SJ. Prevalence and risk factors of urinary tract infection in pregnant women. Rev Med Inst Mex Seguro Soc. 2023;61(5):590–6. doi:10.5281/zenodo.8316437.

3. Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A. What we do and do not know about women and kidney diseases: questions unanswered and answers unquestioned. Physiol Int. 2018;105(1):1–18. doi:10.1556/2060.105.2018.1.6.

4. Piccoli GB, Attini R, Cabiddu G. Kidney diseases and pregnancy: a multidisciplinary approach for improving care. J Clin Med. 2018;7(6):135. doi:10.3390/jcm7060135.

5. Jeyabalan A, Lain KY. Anatomic and functional changes of the upper urinary tract during pregnancy. Urol Clin North Am. 2007;34(1):1–6. doi:10.1016/j.ucl.2006.10.008.

6. Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in Nairobi, Kenya. Pan Afr Med J. 2017;26:41. doi:10.11604/pamj.2017.26.41.10975.

7. Pérez-Moreno MO, Picó-Plana E, Grande-Armas J, et al. Group B streptococcal bacteriuria during pregnancy and risk of maternal intrapartum colonization: a prospective cohort study. J Med Microbiol. 2017;66(4):454–60. doi:10.1099/jmm.0.000465.

8. Shen W, Zhu L. Analysis of risk factors for urinary tract infections in pregnant women: a retrospective study. Arch Esp Urol. 2024;77(5):525–30. doi:10.56434/j.arch.esp.urol.20247705.72.

9. Glaser AP, Schaeffer AJ. Urinary tract infection and bacteriuria in pregnancy. Urol Clin North Am. 2015;42(4):547–60. doi:10.1016/j.ucl.2015.05.004.

10. El-Kashif MML. Urinary tract infection among pregnant women and its associated risk factors: a cross-sectional study. Biomed Pharmacol J. 2019;12(4):1–6. doi:10.13005/bpj/1832.

11. Sulemanji M, Vakili K. Neonatal renal physiology. Semin Pediatr Surg. 2013;22(4):195–8. doi:10.1053/j.sempedsurg.2013.10.008.

12. Geraud N, Casemayou A, Alves M, et al. Predictive performance of fetal urinary inflammatory markers for postnatal kidney function in fetuses with posterior urethral valves. Pediatr Nephrol. 2025;40(4):1023–32. doi:10.1007/s00467-024-06608-x.

13. Saccone G, D’Alessandro P, Escolino M, et al. Antenatal intervention for congenital fetal lower urinary tract obstruction: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2020;33(16):2664–70. doi:10.1080/14767058.2018.1555704.

14. Fogo AB. Pediatric renal pathology. In: Avner E, Harmon W, Niaudet P, Yoshikawa N, Emma F, eds. Pediatric Nephrology. Berlin: Springer; 2016. p.705–49. doi:10.1007/978-3-662-43596-0_22.

15. Yen CW, Chen TD, Yen TH, Yu MC. Pathological spectrum of pediatric kidney disease: 18-year experience from a single tertiary care center in northern Taiwan. Pediatr Neonatol. 2023;64(1):26–31. doi:10.1016/j.pedneo.2022.07.005.

16. Levey AS, Eckardt KU, Tsukamoto Y, et al. Definition and classification of chronic kidney disease: a position statement from KDIGO. Kidney Int. 2005;67(6):2089–100. doi:10.1111/j.1523-1755.2005.00365.x.

17. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1–266. PMID:11904577.

18. Hogg RJ, Furth S, Lemley KV, et al. National Kidney Foundation Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents. Pediatrics. 2003;111(6 Pt 1):1416–21. doi:10.1542/peds.111.6.1416.

19. Urinary tract infections in pregnant individuals. Obstet Gynecol. 2023;142(2):435–45. doi:10.1097/AOG.0000000000005269.

20. Ribeiro-do-Valle CC, Bonet M, Brizuela V, et al. Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS). Ann Clin Microbiol Antimicrob. 2024;23(1):21. doi:10.1186/s12941-024-00681-8.

21. Chu CM, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol. 2018;219(1):40–51. doi:10.1016/j.ajog.2017.12.231.

22. Molina-Muñoz JS, Cuadrado-Angulo J, Grillo-Ardila CF, et al. Consensus for the treatment of upper urinary tract infections during pregnancy. Rev Colomb Obstet Ginecol. 2023;74(1):37–52. doi:10.18597/rcog.3984.

23. Guo X, Xue F. Textbook of medical statistics. Zhengzhou: Zhengzhou University Press; 2024. p.220. doi:10.1007/978-981-99-7390-3.

24. Son MH, Yim HE. Risk factors for recurrent urinary tract infections in young infants under 24 months. Child Kidney Dis. 2024;28(1):35–43. doi:10.3339/ckd.24.003.

25. Veauthier B, Miller MV. Urinary tract infections in young children and infants: common questions and answers. Am Fam Physician. 2020;102(5):278–85. PMID:32866365.

26. Gebretensaie Y, Atnafu A, Girma S, Alemu Y, Desta K. Prevalence of bacterial urinary tract infection, associated risk factors, and antimicrobial resistance pattern in Addis Ababa, Ethiopia. Infect Drug Resist. 2023;16:3041–50. doi:10.2147/IDR.S402279.

27. Janardhan S, Kim S, Cukovic B, Demissie S, Roth P, Blau J. Urinary tract infections in low birth weight neonates. Am J Perinatol. 2024;41(Suppl 1):e775–9. doi:10.1055/s-0042-1757454.

28. Myroshnychenko MS, Mishyn YM, Pasiyeshvili NM, et al. Etiological features of urinary tract infections in pregnant women: current state of the problem. Kidneys. 2023;12(3):28–33. doi:10.22141/2307-1257.12.3.2023.417.

29. de Souza HD, Diório GRM, Peres SV, Francisco RPV, Galletta MAK. Bacterial profile and prevalence of urinary tract infections in pregnant women in Latin America: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2023;23(1):774. doi:10.1186/s12884-023-06060-z.