Factors associated with pregnancy related complications in women with a history of vesicoureteral reflux: A systematic review by the EAU-YAU Paediatric Urology Working Group
ACTAS UROLOGICAS ESPANOLAS, vol.49, no.8, 2025 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 49 Issue: 8
- Publication Date: 2025
- Doi Number: 10.1016/j.acuro.2025.501821
- Journal Name: ACTAS UROLOGICAS ESPANOLAS
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE, DIALNET
- Istanbul University Affiliated: No
Abstract
Introduction: Vesicoureteral reflux (VUR) may have long lasting effects on affected individuals, especially in females. Its intertwined relationship with urinary tract infection (UTI) has been well documented and there is a further risk during pregnancy where UTIs are more problematic. Objective: To analyze existing data within the literature to identify factors associated with pregnancy-related complications in women with a history of VUR in childhood. Methods: PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify all published reports of pregnancy outcomes in women with a history of VUR in childhood up to January 2024 (PROSPERO Registration ID: CRD42024550470). Selection criteria included all English-language original articles reporting pregnancy outcomes (maternal and fetal morbidities) in pregnant patients with a history of VUR in childhood. After screening and eligibility assessment, 17 articles met the PICO inclusion criteria. Results: The search yielded 1060 papers, of which 17 remained after exclusions, and assessed 2349 women with a history of VUR in childhood, 1167 pregnant women and a total of 2206 pregnancies. Compared with the general obstetric population, the results showed an increased rate of pregnancy-related complications (particularly febrile urinary tract infection, gestational hypertension, pre-eclampsia) in the presence of renal scarring, even if the women had undergone anti-reflux surgery in childhood, but not persistent low-grade VUR. Conclusion: Despite the lack of larger prospective randomized controlled trials with long-term follow-up, based on the findings of this systematic review, we conclude that close monitoring during pregnancy should be recommended in the presence of persistent high-grade VUR or in women with renal scarring, even if VUR has resolved. (c) 2025 AEU. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.