Hospital admissions in children who had pelvicalyceal diltation detected on ultrasound scan during pregnancy: an e-cohort study IJPDS (2017) Issue 1, Vol 1:305 Proceedings of the IPDLN Conference (August 2016)

Main Article Content

Melissa Wright
Shantini Paranjothy
David Fone
Sinead Brophy
Joanne Demmler
Published online: Apr 19, 2017


ABSTRACT

Objective

To explore whether children with pelvicalyceal dilatation (PCD, a marker detected during the 18-20 week gestation ultrasound scan in which there is enlargement of tubes that collect urine in the kidney) have more hospital admissions for kidney problems in childhood compared to children without the marker.


Approach
We were funded by NISCHR to study outcomes associated with markers of uncertain significance at the second trimester anomaly scan (Welsh Study of Mothers and Babies). Data collected in the WSMB was uploaded to the Secure Anonymised Information Linkage (SAIL) databank and record linked to hospital activity data. Patterns of hospital admissions for renal causes were described and compared between those with no markers and those with PCD. Children were followed up from birth until 31st December 2014 or until the age of 5. A Cox Proportional Hazard Model was used to investigate the impact of PCD on time to first presentation.


Results (Preliminary)
Of the WSMB cohort, 20,834 children were eligible for inclusion in analyses. Those with PCD had 6.29 times the hazard of a renal admission compared to those without the marker (95% CI: 3.69 to 10.72). Children with PCD were more likely to have multiple renal admissions to hospital - median (interquartile range) number of renal admissions, 2.5 (1 to 5) compared to 1 (1 , 1) in children without markers.


Conclusion
Preliminary analysis suggests there is increased childhood renal morbidity associated with the presence of a PCD marker detected on the 18-20 week gestation ultrasound scan. These findings will inform the discussions clinicians have with parents when discussing the implications of this marker for the health of the chid.


Background

This paper examines whether experiences of young people who are not in employment, education or training (NEET) are associated with adverse long-term outcomes in health. We used the Scottish Longitudinal Study (SLS), which includes information from the 1991, 2001, and 2011 censuses as well as from vital events, for a 5.3% representative sample of the Scottish population. Linked health data such as hospital admissions and prescribing in general practice are also available. We followed around 14,000 young people who were aged 16-19 in 1991 up to 2011.

Method

We explored whether NEET young people in 1991 displayed higher risks of poor physical and mental health in the follow-up period. Poor physical health is measured by any admission into hospital and poor mental health is measured by prescription of anti-depressant and anti-anxiety medicine. We used descriptive and modelling approaches in our analysis. Covariates include a number of individual socioeconomic characteristics and local area characteristics in the models.

Results

Our research found that over 40% of the cohort members have been admitted into hospital, while over 30% have been prescribed with anti-depressant and anti-anxiety drugs. The NEET status in 1991 appears to be associated with hospitalisation with adjusted odds ratio (OR) of 1.24 (95% Confidence Intervals (CIs): 1.08 – 1.42). Also the NEET experiences are associated with poor mental health with OR of 1.47 (95% CI: 1.27 – 1.71). Policy intervention is necessary in assisting NEET young people to re-engage in education or employment.

Article Details

Most read articles by the same author(s)