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



Congenital abnormalities of the kidney and urinary tract (CAKUT) are diagnosed in up to 1 % of pregnancies and account for 20–30 % of the abnormalities identified in the prenatal period. In previous studies, maternal obesity has been associated with congenital malformations in offspring. Our aim was to evaluate the association between maternal obesity [body mass index (BMI) ≥ 30 kg/m2] and CAKUT in offspring.


We conducted a population-based, case–control study using linked birth–hospital discharge records from Washington State, 2003–2012. We identified 3093 CAKUT cases using International Classification of Diseases, Ninth Revision (ICD-9) codes. Controls were defined as births without any ICD-9 codes denoting congenital malformations, matched to cases by year of birth in an approximate 4:1 ratio.


Compared to controls, mothers giving birth to infants with CAKUT were more likely to be obese [odds ratio (OR) 1.24, 95 % confidence interval (CI) 1.11–1.38]. We found a significant positive trend between odds of CAKUT in offspring and increasing severity of obesity (score test for trend of odds p < 0.001). This association remained significant in offspring with isolated CAKUT (OR 1.19, 95 % CI 1.06–1.35) and upper urinary tract anomalies (OR 1.26, 95 % CI 1.13–1.41). Maternal overweight (BMI 25–29.9 kg/m2) was not associated with CAKUT in offspring.


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.

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The authors would like to thank Victoria Holt, PhD, MPH, Stephen Hawes, PhD, MS, Alyson Littman, PhD, MPH, and Bill O’Brien from the Department of Epidemiology, School of Public Health, University of Washington, as well as the Washington State Department of Health. We would like to thanks the National Institute of Diabetes and Digestive and Kidney Diseases for providing fellowship funding for Dr. Macumber (Grant # T32DK007662). We would like to thank Joseph Flynn, MD, MS, from Seattle Children’s Hospital for editorial review of the manuscript.

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Correspondence to Ian Macumber.

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The study was approved by the University of Washington Human Subjects Division and deemed exempt from review by the Institutional Review Board as the data accessed were anonymous and did not allow identification by the authors of individual patients or their medical charts.


The authors have no competing financial interests to disclose.

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The authors declare that they have no conflict of interest.

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Macumber, I., Schwartz, S. & Leca, N. Maternal obesity is associated with congenital anomalies of the kidney and urinary tract in offspring. Pediatr Nephrol 32, 635–642 (2017).

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  • Obesity
  • Maternal obesity
  • Congenital anomalies of kidney and urinary tract
  • Chronic kidney disease