Bacteriuria, Prematurity, and the Hypertensive Disorders of Pregnancy

Clinical risk factors for preeclampsia

“…However, a definite conclusion from this literature as to whether urinary tract infection is a risk factor for the development of preeclampsia is not possible due to the varying definitions used for urinary tract infections and preeclampsia. Stuart et al [30] reported in a prospective case-control study of 2,713 consecutive pregnancies a positive association of bacteriuria and hypertensive disorders of pregnancy (18.2% of cases vs. 4.5% of controls). It has been suggested that urinary tract infection during pregnancy is merely a correlate of prior infectious renal damage that may predispose the women to preeclampsia [31].…”

Urinary tract infection during pregnancy: its association with maternal morbidity and perinatal outcome.

“…1,3,5,6,12,15,26 Assuming that the association between urinary tract infection and prematurity is real, the mechanism by which then, that the effect of urinary tract infection on premature birth could be indirectly mediated by occult renal abnormalities that result in antepartum maternal complications such as hypertension/ preeclampsia or anemia. Our data do not support this hypothesis, because no change in the odds ratio was observed for the association between urinary tract infection and preterm low birthweight when women with either hypertension or anemia were excluded from analysis.…”

“…At present, the only certain conclusion is that the risk of progression to pyelonephritis greatly increases during pregnancy, with rates as high as 30% reported among untreated women. [1][2][3][4][5][6][7] Antepartum urinary tract infection has also been implicated as a risk factor for adverse perinatal outcomes-premature birth and/or low birthweightl,3-5'7-14 and perinatal deathl"4'9-in numerous observational studies. However, an equal number of negative findings have been reported.2'6"15-28 Results tritis.…”

Bacterial infection in the fetus and newborn.

“…Patrick (1967) recorded a significantly increased incidence of asymptomatic bacteriuria and clinical pyelonephritis among the newborn infants of bacteriuric mothers compared to controls, but this has not been confirmed by Gower et al (1970). The association of prematurity and pregnancy bacteriuria postulated by Kass (1962) has been confirmed by some (Stuart, Cummins, and Chin, 1965;Wren, 1969) and disputed by others (Bryant et al, 1964;Dixon and Brant, 1967). Gruneberg, Leigh, and Brumfitt (1969) reported significantly lower birthweights in infants born to bacteriuric mothers compared with controls.…”