Trends in prenatal sonography use and subsequent urologic diagnoses and abortions in the United States

Objectives: Prenatal sonography has enabled fetal diagnosis of urologic conditions and is now commonly used in the US. The impact of this technology on the incidence of pediatric urological diagnoses is unknown. We sought to assess trends in prenatal sonography and resulting urologic diagnoses and/or abortions. Methods: Using administrative codes in Ingenix, a claims database of individuals with employer-based insurance, we identified women undergoing prenatal ultrasounds (1998-2005). These were linked to claims for subsequent abortions, live births, and postnatal urologic diagnoses in resulting offspring. Results: 99.07% of women underwent ultrasound and childbirth. Ultrasound use among women whose pregnancies proceeded to birth increased from 90,568 to 96,866 per 100,000 mother-infant pairs from 1998 to 2005. Of women who did or did not undergo ultrasounds, 1.25% and 0.66% had infants with urologic diagnoses, respectively. The rates of prenatal ultrasound-detected urinary tract anomalies increased from 1032.26 per 100,000 live births in 1999 to 1225.71 per 100,000 live births in 2005. Conclusions: Prenatal ultrasound is widely used, but increased utilization of this diagnostic modality did not seem to be associated with abortions. The rate of pediatric urologic diagnoses in infants who had received prenatal ultrasound did not rise significantly over time. © 2009 Journal of Pediatric Urology Company