Anomalías congénitas urológicas: Descripción epidemiológica y factores de riesgo asociados en Colombia 2001-2004

Objective: To determine the incidence of congenital anomalies of the urinary tract in Colombia and study their association with maternal risk factors. Methods: We performed a register based, case control study using the data from the ECLAMC (Colaborative Latinoamerican Study for Congenital Malformations) in Colombia, between June, 2001 and December, 2004. Positive Registries for any urological anomaly were selected. Calculations for the incidence of each abnormality were done. Odds ratio were estimated for 11 maternal variables. Results: 83 positive registries were found. The established incidence was 0,43%. These anomalies accounted for 9,4% of the total of malformations. The obtained rate (× 10.000 births) for each anomaly was: hypospadias 17,7; chryptorchidism 13,3; hydronephrosis 2,6; cystic renal disease 2,6; undeterminate sex 2,6; unilateral renal agenesis 1, 3; micropenis 1,9; bilateral renal agenesis 0,7; patent urachus 0,3. The risk for renal defects increased with preterm birth, odds ratio OR= 3,66; 95% IC [1, 13-13,82] and maternal chronic disease OR= 6,18; 95% Cl [1,09-34,98]. A deterministic association was found with consanguinity between the parents. The positive associations for genital defects were: low birth weight OR= 4,07; 95% Cl [2,00-8,25], preterm birth OR=3,80; 95% Cl [1,87-7,72], presence of malformated individuals in the family OR= 2,30; 95% Cl [1,02-5,25], and smoking during pregnancy OR= 5,36; IC [1,01-28,51]. A deterministic association was found with alcohol ingestion during pregnancy. Conclusions: The prevalence of anomalies of the urinary tract in Colombia is considerably lower in comparison with european and northamerican statistics. The birth weight is the most important risk factor for anomalies like hypospodias and chriptorchidism. Consanguinity between the parents and alcohol ingestion during the pregnancy are determinant on the risk for renal and genital anomalies, respectively. Variables like smoking during pregnancy and chronic maternal disease must be deeply explored in the future to determine their role in the etiology of these defects.