{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:41:44Z","timestamp":1760060504819,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Motor vehicle accidents account for the majority of abdominal trauma in pregnancy and can result in fetal morbidity and mortality. With advancing gestation, the fetus becomes more vulnerable to injury. Case presentation: A preterm neonate is born at 32 weeks\u2019 gestation via cesarean section due to placental abruption after maternal motor vehicle accident. Initially, the infant presented with anemia, thrombocytopenia, and acute kidney injury in the setting of renal contusions. Results: Hyponatremia, acidosis, oliguria, and uremia progressed to frank anuric renal failure, requiring several months of hemodialysis before transition to peritoneal dialysis for chronic renal replacement therapy at home. Conclusions: Fetal renal injury resulting in postnatal renal failure is a rare but potentially devastating complication of blunt abdominal injury during pregnancy. Sonographic and laboratory evaluation of a neonate with suspected in utero injury after maternal motor vehicle accident is imperative, as is a high index of suspicion for neonatal renal injury.<\/jats:p>","DOI":"10.3390\/children12091179","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T08:08:46Z","timestamp":1756973326000},"page":"1179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal Renal Failure After Maternal Motor Vehicle Accident"],"prefix":"10.3390","volume":"12","author":[{"given":"Jasmine Y.","family":"Massoumi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Los Angeles General Medical Center, Los Angeles, CA 90033, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline M.","family":"Bebawy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Los Angeles, Los Angeles, CA 90027, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1842-8860","authenticated-orcid":false,"given":"Sheema","family":"Gaffar","sequence":"additional","affiliation":[{"name":"Fetal and Neonatal Institute, Division of Neonatology, Children\u2019s Hospital of Los Angeles, Los Angeles, CA 90027, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S385","DOI":"10.1097\/01.CCM.0000182808.99433.55","article-title":"Trauma in Pregnancy","volume":"33","author":"Mattox","year":"2005","journal-title":"Crit. 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Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3109\/14767058.2014.918094","article-title":"Motor\u2013Vehicle Injury in Pregnancy and Subsequent Feto-Maternal Outcomes: Of Grave Concern","volume":"28","author":"Chibber","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/01.PCC.0000123549.26173.DD","article-title":"Fetal Intracranial Injuries in a Preterm Infant after Maternal Motor Vehicle Accident: A Case Report","volume":"5","author":"Hagmann","year":"2004","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1038\/sj.jp.7200085","article-title":"Fetal Morbidity and Mortality Following Motor Vehicle Accident","volume":"19","author":"Parida","year":"1999","journal-title":"J. Perinatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1542\/neo.21-5-e342","article-title":"Case 1: Neonatal Trauma Following Motor Vehicle Collision in Pregnancy","volume":"21","author":"Shashy","year":"2020","journal-title":"Neoreviews"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Coleman, C., Tambay Perez, A., Selewski, D.T., and Steflik, H.J. (2022). Neonatal Acute Kidney Injury. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.842544"},{"key":"ref_10","unstructured":"Voigt, B., and Springel, T. (2019). Chapter 93: The Kidney and Urinary Tract of the Neonate. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant, Elsevier."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/01.pcc.0000256612.40265.67","article-title":"Risk Factors of Acute Renal Failure in Critically Ill Children: A Prospective Descriptive Epidemiological Study","volume":"8","author":"Bailey","year":"2007","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1542\/peds.82.2.216","article-title":"Hematuria and Clinical Findings as Indications for Intravenous Pyelography in Pediatric Blunt Renal Trauma","volume":"82","author":"Lieu","year":"1988","journal-title":"Pediatrics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.urology.2017.09.030","article-title":"Renal Trauma in Pediatrics: A Current Review","volume":"113","year":"2018","journal-title":"Urology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2023061957","DOI":"10.1542\/peds.2023-061957","article-title":"Standards for Levels of Neonatal Care: II, III, and IV","volume":"151","author":"Stark","year":"2023","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e463","DOI":"10.1542\/peds.2014-3819","article-title":"Neonatal Acute Kidney Injury","volume":"136","author":"Selewski","year":"2015","journal-title":"Pediatrics"},{"key":"ref_16","unstructured":"Goldsmith, J. (2019). Chapter 31: Overview and Initial Management of Delivery Room Resuscitation. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant, Elsevier."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e13133","DOI":"10.1097\/MD.0000000000013133","article-title":"Fetal Closed Head Injuries Following Maternal Motor Vehicle Accident: A clinicopathologic case report","volume":"97","author":"Nishida","year":"2018","journal-title":"Medicine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1542\/peds.70.6.993","article-title":"Motor Vehicle Occupant Injuries to Children in Crash and Noncrash Events","volume":"70","author":"Agran","year":"1982","journal-title":"Pediatrics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e20190829","DOI":"10.1542\/peds.2019-0829","article-title":"State-of-The-Art Renal Imaging in Children","volume":"145","author":"Viteri","year":"2020","journal-title":"Pediatrics"},{"key":"ref_20","first-page":"11","article-title":"Pediatric Abdominal Trauma: Evaluation by Computed Tomography","volume":"82","author":"Kane","year":"1988","journal-title":"Pediatrics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/01.PCC.0000244428.31624.AB","article-title":"Blunt Bowel and Mesenteric Injuries in Children: Do Nonspecific Computed Tomography Findings Reliably Identify These Injuries?","volume":"7","author":"Peters","year":"2006","journal-title":"Pediatr. 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Gynecol."},{"key":"ref_25","first-page":"207","article-title":"Seat Belts: A Potential Hazard to the Fetus","volume":"15","author":"Chetcuti","year":"1987","journal-title":"PubMed"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1179\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:39:07Z","timestamp":1760035147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["children12091179"],"URL":"https:\/\/doi.org\/10.3390\/children12091179","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,9,4]]}}}