Work

Risk of congenital malformation in newborns from mothers with kidney diseases in a nationwide cohort study

Year: 2026

Type: article

Abstract: Maternal chronic kidney disease (CKD) is associated with an increased risk of adverse pregnancy outcomes. However, the overall risk of congenital malformations (CMs) in offspring of mothers with kidney disease, including CKD and end-stage kidney disease (ESKD), remains unclear. In this nationwide cohort study, we analyzed National Health Insurance Service (NHIS) data from 2,680,092 women who gave birth between 2008 and 2017. Major CMs were identified using the International Classification of Diseases-10 (ICD-10) codes during the first 12 months after birth. A multivariable generalized estimating equation model was used to compare the risk of CMs between women with CKD or ESKD, including those on dialysis and post-kidney transplantation (KT), and healthy controls. Major CMs prevalence is 4.79% in offspring of healthy mothers, 5.29% in CKD mothers, and 9.65% in ESKD mothers, with congenital heart defects being the most common anomaly across all groups. After adjustment, mothers with kidney diseases show a higher risk of major CMs than healthy controls (adjusted odds ratio [aOR], 1.07; 95% confidence interval [CI], 1.03–1.11 in CKD; aOR, 1.71; 95% CI, 1.16–2.52 in ESKD, respectively). Among ESKD patients, KT recipients show an increased risk (aOR, 1.65; 95% CI, 1.06–2.59), but dialysis patients do not reach statistical significance (aOR, 2.02; 95% CI, 0.92–4.41). Our findings suggest that neonates born to mothers with kidney diseases have an increased risk of CMs compared to those born to healthy mothers. Chronic kidney disease (CKD) in women can increase health problems during pregnancy, but its impact on birth defects in babies is not well understood. In this study, we used South Korea’s National Health Insurance Service data from 2008 to 2017 to investigate whether babies born to mothers with kidney disease have a higher chance of birth defects. We compared mothers with CKD, those receiving dialysis, and those who had a kidney transplant with mothers without kidney disease. We found that babies of mothers with kidney disease had a higher risk of birth defects involving several major organs. These findings show the importance of early counseling, close monitoring, and careful prenatal care for women with kidney disease. Han et al. examined nationwide insurance data from South Korea to evaluate congenital malformations in offspring born to mothers with chronic or end-stage kidney disease. They found that maternal kidney disease is associated with increased risks of congenital malformations compared with healthy mothers.

Source: Communications Medicine

DOI: 10.1038/s43856-026-01397-w