A study of risk factors and consequences of asymptomatic bacteriuria in pregnant women and feto-maternal outcome

Byna, Prasanna; Muvva, Naimisha; Kolli, Swathi; Shaik, Mahaboob Vali

doi:10.18203/2320-1770.ijrcog20150700

Cited by 5 publications

(7 citation statements)

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“…Such association may be explained by increased rates of PROM, preterm labor, and Intrauterine growth restriction associated with ASB. 33 It is established that off-springs born via CD have a less diverse microbiome than those born through vaginal delivery, possibly increasing susceptibility to infectious outcomes. 34 Such an association between increased pediatric infections and CD has been reported previously.…”

Section: Journal Of Developmental Origins Of Health and Diseasementioning

confidence: 99%

The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations

Nae

Wainstock

2021

J Dev Orig Health Dis

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Asymptomatic bacteriuria (ASB) is a well-acknowledged infectious entity during pregnancy; yet its long-term implications are not well investigated. The present study aimed to test the association between maternal ASB during pregnancy and long-term offspring infectious hospitalizations. A population-based cohort analysis was conducted, comparing the incidence of long-term infectious-related hospitalizations of offspring born to mothers who were diagnosed with ASB during pregnancy, and those who did not have ASB. The study was conducted at a tertiary medical center and included all singleton deliveries between the years 1991 and 2014. Infectious morbidities were based on a predefined set of International Classification of Disease-9 codes. A Kaplan−Meier survival curve compared cumulative infectious hospitalization incidence between the groups, and a Cox regression model was used to adjust for confounding variables. During the study period, 212,984 deliveries met inclusion criteria. Of them, 5378 (2.5%) were diagnosed with ASB. As compared to offspring of non-ASB mothers, total long-term infectious hospitalizations were significantly higher among children to mothers who were diagnosed with ASB (13.1% vs. 11.1%, OR = 1.2, 95% CI 1.11–1.30, P ≤ 0.001). Likewise, a Kaplan−Meier curve demonstrated higher cumulative incidence of infectious hospitalizations among children born to mothers with ASB (log rank, P = 0.006). In the Cox regression model, while controlling for maternal age, diabetes mellitus, ethnicity, hypertensive disorders, and gestational age, maternal ASB was noted as an independent risk factor for long-term infectious morbidity in the offspring (adjusted HR = 1.1, 95% CI 1.01–1.17, P = 0.042). ASB during pregnancy increases offspring susceptibility to long-term infectious hospitalizations.

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Section: Journal Of Developmental Origins Of Health and Diseasementioning

confidence: 99%

The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations

Nae

Wainstock

2021

J Dev Orig Health Dis

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“…The prevalence of asymptomatic bacteriuria in pregnant women is affected by many risk factors [13][14][15]. Some of the factors include socioeconomic status, history of recurrent urinary tract infection, diabetes mellitus, and anatomical abnormalities of the urinary tract, sickle cell disease, and retroviral disease [14][15]. Sickle cell disease has been found to even double the risk in some studies [16].…”

Section: Trial Registration Numbermentioning

confidence: 99%

Burden of Asymptomatic Bacteriuria Amongst Nigerian Pregnant Women: A Protocol for Systematic Review and Meta-Analysis

Onwusulu

Okoye

Nna³

et al. 2021

Preprint

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BackgroundAsymptomatic bacteriuria can be a cause of adverse pregnancy and neonatal outcomes if undetected and untreated. Pregnant women are usually routinely screened with urine cultures at antenatal booking. However, the exact burden of asymptomatic bacteriuria in Nigeria is unknown. Our protocol is aimed at determining the pooled prevalence of asymptomatic bacteriuria amongst Nigerian pregnant women as well as the associated risk factors and pregnancy outcomes.MethodsNine databases: PubMed, African Journal Online, Google Scholar, Cochrane Library, CINAHL, Embase, ResearchGate, Scopus, and Web of Science will be searched using a search strategy that is developed by combinations of MeSH terms, keywords, text words, and entry terms. Only observational studies published or retrievable in the English Language will be included. Studies must be conducted in Nigeria. The primary measurable outcome of this study is the prevalence of asymptomatic bacteriuria in pregnant women. Identified studies will be screened, selected, and deduplicated in DistillerSR. Data items will be extracted into predefined forms in the DistillerSR. Reports including Prisma flow chart, quality scores, risk of bias, and study outcomes will be generated in DistillerSR. Extracted data items will be exported into the Comprehensive Meta-analysis Software version 3 for quantitative analysis. Methodological, clinical, and statistical heterogeneity will be assessed for all the studies. Publication bias will be assessed using Funnel plots. There will be a subgroup analysis of pooled prevalence using categorical variables. The primary outcome will be expressed in pooled prevalence, standard error, variance, and 95% CI of variance. Quantitative risk factors and pregnancy outcomes will be used used for meta-regression. The reporting of the systematic review and meta-analysis will be according to PRISMA 2015 Statement.DiscussionThe pooled prevalence of asymptomatic bacteriuria in Nigeria will be examined in relation to associated risk factors and pregnancy outcomes. The study will be published in a peer-reviewed scientific journal.Trial Registration NumberThis protocol is registered with the Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42020213810

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“…Pregnancy accelerates the progression of ASB to symptomatic bacteriuria in 40% of the women which can pave way to acute kidney failure. [ 4 ] ASB can also lead to symptomatic cystitis which can progress to pyelonephritis. Pyelonephritis is the most severe complication of ASB and is associated with preterm labor and delivery in 13.3% of the women.…”

Section: Introductionmentioning

confidence: 99%

“…This leads to mid-term abortions, still births, low birth weight, and intra uterine growth restriction. [ 4 ] Products released by the bacteria such as mucinases and pro inflammatory toxins break down the mucus plug which leads to premature rupture of membranes which is a predisposition to the onset of preterm labor. Additionally, due to the breakdown of the mucus plug and the underdeveloped immunological system of the fetus, bacteria colonize and multiply in the fetus with ease, leading to septicaemia.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, due to the breakdown of the mucus plug and the underdeveloped immunological system of the fetus, bacteria colonize and multiply in the fetus with ease, leading to septicaemia. [ 4 ] Other complications include oligohydramnios, polyhydramnios, perinatal death of fetus,[ 6 ] and higher incidences of recurrent pregnancy loss.…”

Section: Introductionmentioning

confidence: 99%

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Asymptomatic bacteriuria of pregnant women in a tertiary care centre

Totadhri

Lakshmanan

et al. 2022

Journal of Education and Health Promotion

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BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to the various morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed, it can lead to conditions such as pyelonephritis and preterm delivery which could culminate in causing maternal and fetal morbidity and mortality. Therefore, this study aims to determine the prevalence, risk factors, microbial profile, and antibiotic susceptibility patterns associated with ASB in a tertiary healthcare center. MATERIALS AND METHODS: A cross-sectional study was carried out where 150 urine samples were obtained from pregnant women within the gestational age of 13–36 weeks. Randomized stratified sampling was the method of sampling used. A questionnaire was also administered to them to determine potential risk factors. The samples were cultured and identified using biochemical tests. Antibiotic susceptibility tests were carried out by Kirby–Bauer disc diffusion method. Statistical analysis was carried out using Chi-square test. The graphs and tables were generated using Microsoft Excel and Word. RESULTS: Out of the 150 samples that were obtained, 8 samples had significant bacteriuria which is a prevalence of 5.33%. Escherichia coli was the most frequently isolated organism accounting to 45% of the isolates. The other organisms that were isolated were Enterococcus, Klebsiella pneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, and Group B Streptococcus which measured to 11% of the total distribution each. In the antibiotic sensitivity tests, among the gram-negative isolates, marked resistance to Ampicillin and Amoxycillin along with sensitivity to Cotrimoxazole and Nitrofurantoin. Of the gram-positive isolates, there was sensitivity to Ampicillin and Nitrofurantoin. A positive correlation was seen between the age groups of 23–27 and the prevalence of ASB. CONCLUSION: The prevalence of ASB in this study shows that ASB is not uncommon in the population. Despite the World Health Organization (WHO) guidelines and National Health Mission recommendations to make urine check-ups a routine, it not carried out, possibly due to cost implications. However, it poses a risk for severe maternal and fetal outcomes and hence, should be screened for on a regular basis. Thus, this study emphasizes the importance of screening pregnant women for ASB for promoting better maternal and fetal health.

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A study of risk factors and consequences of asymptomatic bacteriuria in pregnant women and feto-maternal outcome

Cited by 5 publications

References 7 publications

The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations

The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations

Burden of Asymptomatic Bacteriuria Amongst Nigerian Pregnant Women: A Protocol for Systematic Review and Meta-Analysis

Asymptomatic bacteriuria of pregnant women in a tertiary care centre

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