The following is a summary of “Long-term Outcomes, Including Fetal and Neonatal Prognosis, of Renal Oligohydramnios: A Retrospective Study over 22 Years,” published in the June 2024 issue of Pediatrics by Nishi et al.

This study aimed to evaluate the extended outcomes of renal oligohydramnios and identify risk factors associated with fetal, neonatal, and postneonatal mortality. Conducted retrospectively from 2002 to 2023, the cohort included fetuses diagnosed prenatally with renal oligohydramnios, excluding cases lost to follow-up. Comprehensive assessments of fetal, neonatal, and long-term outcomes and an analysis of associated risk factors were performed.

Among the 131 fetuses identified with renal oligohydramnios, outcomes revealed that 35% underwent termination of pregnancy, 8% experienced intrauterine fetal demise, 20% suffered neonatal death, 7% encountered postneonatal mortality, and 30% survived beyond the neonatal period. Logistic regression analyses highlighted earlier gestational age at onset (OR 1.16, 95% CI 1.01–1.37) significantly correlated with intrauterine fetal death, while anhydramnios (OR 12.7, 95% CI 1.52–106.7) emerged as a significant predictor of neonatal mortality. Notably, survival rates varied across different renal conditions, with bilateral renal agenesis and bilateral multicystic dysplastic kidney (MCDK) demonstrating lower neonatal survival rates than other renal anomalies. However, select cases of bilateral renal agenesis and bilateral MCDK achieved survival through fetal intervention. Kaplan–Meier estimates indicated survival rates of 57%, 55%, and 51% at 1, 3, and 5 years, respectively. In the Cox proportional hazards model, birth weight <2000 g (HR 7.33, 95% CI 1.48–36.1) and gastrointestinal comorbidities (HR 4.37, 95% CI 1.03–18.5) emerged as significant risk factors for postneonatal mortality.

In conclusion, achieving long-term survival in cases of renal oligohydramnios is feasible with appropriate risk assessment. This study underscores the importance of early identification and management strategies to mitigate adverse outcomes, particularly in severe renal anomalies and associated comorbidities.

Source: sciencedirect.com/science/article/abs/pii/S0022347624002543