Asymptomatic bacteriuria in pregnancy and its relation to perinatal outcome

Introduction: Asymptomatic bacteriuria in pregnancy (ABU) is poorly understood and neglected in developing countries. It causes certain lethal maternal and fetal consequences if left untreated including low weighted births, premature delivery, full-blown urinary tract infection and pyelonephritis. Objective: Our aim was to explore such factors having bad impact on pregnancy associated with asymptomatic bacteriuria and aware our community about these unspoken perils so that ABU likelihood may be reduced. Prevalence varies country to country. Developing and low economic countries are suffered more than developed so thereby upgrading and providing basic amenities of life the risk factors may be reduced. Materials and Methods: This was a cross sectional study carried out in department of pathology PUMHSW. Sample size was 377, all selected were 18 years and above. All urinary samples were collected in sterile container and labeled and immediately transported to microbiology laboratory. Dipstick test, wet mount microscopy and Gram's staining were done. Blood, MacConkey's agar was inoculated and streaked with inoculi. Data were analyzed using SPSS version 23. Results: Samples found unlabeled (02) and contaminated (03) were dropped from study. A total of 372 were study samples. The most of patients were Gram negative 65(90.20%) predominantly Enterobacteriocae. When cultured, 72 were found growth positive (mixed plus pure) while 300 were negative. Risk factors were assayed in culture positive patients (ABU). A large number of patients (74%) belonged to lower economic class. Most common age group varied from 26-30 years (43%). Third trimester was the most common found in 37 patients ((49.3%). Gravid (G3 or more) were strong risk factors and were 55(73.3%). Most of patients were illiterate 65 (90.27%). The past history of UTI was a significant risk 46(63.88%) while anemia was found statistically insignificant 17(23.61). Conclusion: Asymptomatic bacteriuria is frequent in pregnant females and significantly increased when compounded by past history of UTI and low socioeconomic status. Therefore, it is necessary for mothers to be screened for ABU. There is a need of rapid and reliable screening methods so that upcoming disease burden can be reduced.

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“…Anemia was detected in 7 (10.0%) patients showing statistically insignificance corroborates with Indian study [18,24].…”

Section: Discussionsupporting

confidence: 86%

“…Prevalence of ABU in pregnancy varies (4% to 23.9%) across the world [14]. It is higher in developing(1-30% ) countries than developed(2-7% ) [15].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors during Pregnancy for Asymptomatic Bacteriuria

Sial

Detho

Memon³

et al. 2021

JPRI

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“…20 A lower prevalence rate of 8.4% and 8.25% was obtained in a study by Lavanya SV et al and Radha S et al respectively. 10,21 This may be because most of the patients in our study were rural women with lower level of education and socioeconomic status.…”

Section: Discussionmentioning

confidence: 86%

Maternofetal outcome in early versus late detected asymptomatic bacteriuria of pregnancy

Guntoory¹,

Penmetsa²,

Rayapu³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONUrinary tract infection is a common medical complication of pregnancy. Women are more susceptible than men due to short urethra and contamination of the urogenital tract with faecal flora due to the proximity of the urogenital tract to the anal canal. Bacteriuria during pregnancy may be classified as Asymptomatic bacteriuria (ASB), infection of the lower urinary tract (cystitis) and infection of the upper urinary tract (pyelonephritis). Pregnancy in itself is a risk factor for the development of urinary tract infection due to the anatomical, physiological and immunological changes that occur in pregnancy. 90% of pregnant women develop urethral dilatation starting by about 6 th week of pregnancy, increase in bladder volume, ABSTRACTBackground: Urinary tract infection in pregnancy is a problem of global significance. Untreated asymptomatic bacteriuria in pregnancy is known to be associated with maternal and foetal outcome in the form of symptomatic urinary tract infection (UTI), acute pyelonephritis, anaemia, pregnancy induced hypertension (PIH), preterm labour (PTL), low birth weight (LBW), intrauterine growth restriction (IUGR) and prematurity. This study is aimed to compare the maternal and foetal outcome of pregnant women with bacteriuria with that of women without bacteriuria and also to see if screening later in pregnancy at 28-37 weeks of gestation is as effective as screening at less than 20 weeks of pregnancy in terms of maternofoetal outcome. Methods: 165 pregnant women attending the antenatal clinic at MIMS, Nellimerla, Vizianagaram district, Andhra Pradesh, India were screened for asymptomatic bacteriuria by urine culture and sensitivity. They were grouped into asymptomatic bacteriuria negative and culture positive groups. Culture positives were further grouped as early detected and late detected group based on the gestational age at sampling. They were followed up till delivery. The maternofoetal outcome was compared between different groups by computing Odd's ratio and P value of less than 0.05 was taken as significant. Results: There was no statistically significant increase in adverse maternofoetal outcome between early detected and bacteriuria negative group. The women of late detected group had greater odds of developing symptomatic UTI, PIH, PTL, LBW, IUGR and neonatal intensive care unit admissions when compared to early detected and bacteriuria negative group which was statistically significant. Conclusions: Screening for asymptomatic bacteriuria early in pregnancy at less than 20 weeks is more effective in reducing the adverse maternofoetal outcome.

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“…12,13 On contrary, Anjana Verma et al from Udaipur, Rajasthan found the incidence of UTI to be 12.27%. 14 Prabhavathi et al from Nothern Andhra Pradesh found the incidence of UTI to be 11.33%. 15 Researchers of developed countries have found a lower incidence of UTI than their counterparts in developing countries.…”

Section: Resultsmentioning

confidence: 98%

“…Most of the studies have identified E.coli as the commonest organism causing urinary tract infection. 14,22…”

Section: Trimestermentioning

confidence: 99%

Study of incidence of urinary tract infection during pregnancy and its effect on maternal and perinatal outcome

Mahor¹,

Malviya²,

Goyal³

2021

Int J Reprod Contracept Obstet Gynecol

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Background: Urinary tract infection is the commonest bacterial infection in pregnancy, especially in developing countries like India. It has several adverse outcomes not only in the mother but also in the fetus. This study aims to determine the incidence of UTI during pregnancy, the commonest micro-organism causing UTI, and to find out the impact of such infection on maternal and fetal outcomes.Methods: This observational study was carried out in the department of obstetrics and gynaecology Deen Dayal Upadhyay Hospital, New Delhi over a period of 10 months. A total of 196 pregnant women attending the outdoor hospital for ANC check-up without any medical disorder or previous adverse pregnancy outcomes were included in this study. Urine routine microscopy was done as a screening test for UTI. They were followed through their pregnancy and puerperium due to any pregnancy complication and perinatal outcome.Results: Incidence of urinary tract infection was 12.2%, of which 8.2% were asymptomatic and 4.08% were symptomatic. It was found that the incidence of UTI was highest in the age group of 18 to 25 years and also found that UTI was more common in the second (16.7%) and third (16.7%) trimester and lowest in the first trimester (5.7%). Women who had anaemia, pregnancy-induced hypertension, preterm labour, chorioamnionitis, perinatal mortality, and puerperal pyrexia had a high incidence of UTI than those who had not.Conclusions: From this study, we concluded that screening for UTI should be a part of routine antenatal care, and also there is a need to initiate an awareness program to educate women about UTI and their adverse fetomaternal outcome so that prompt and effective treatment can be done.

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Asymptomatic bacteriuria in pregnancy and its relation to perinatal outcome

Cited by 11 publications

References 13 publications

Risk Factors during Pregnancy for Asymptomatic Bacteriuria

Risk Factors during Pregnancy for Asymptomatic Bacteriuria

Maternofetal outcome in early versus late detected asymptomatic bacteriuria of pregnancy

Study of incidence of urinary tract infection during pregnancy and its effect on maternal and perinatal outcome

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