Maternal and neonatal consequences of treated and untreated asymptomatic bacteriuria in pregnancy: a prospective cohort study with an embedded randomised controlled trial

Recommendations on screening for asymptomatic bacteriuria in pregnancy

“…In total, there were 15 eligible studies, including one new study identified during the search update. 4 Eleven studies were RCTs, and four were nonrandomized controlled clinical trials. All but one, in Jamaica, 20 were conducted in high-income countries, including the US, 6,[21][22][23][24] United Kingdom, [25][26][27] Ireland, 28 Australia, [29][30][31] Denmark 32 and the Netherlands.…”

“…All but one, in Jamaica, 20 were conducted in high-income countries, including the US, 6,[21][22][23][24] United Kingdom, [25][26][27] Ireland, 28 Australia, [29][30][31] Denmark 32 and the Netherlands. 4 Studies varied in terms of testing protocols (e.g., timing during pregnancy, number of confirmatory urine…”

“…[4][5][6][7] Pyelonephritis has been associated with maternal septicemia, renal dysfunction and anemia, 8 as well as adverse fetal outcomes, such as low birth weight and preterm birth. 3,9 Conversely, a recent study found asymptomatic bacteriuria was not associated with preterm birth.…”

“…3,9 Conversely, a recent study found asymptomatic bacteriuria was not associated with preterm birth. 4 Hence, the relationship between asymptomatic bacteriuria and pregnancy complications is uncertain.…”

Testing for asymptomatic bacteriuria in pregnancy

“…The potential benefits of treating patients with proteinuria and bacteriuria with antibiotics must also be put into context. Recent literature concerning ASB screening in pregnancy determined that routine screening for ASB had limited clinical impact, preventing only one case of pyelonephritis per 1000 screened women [5].It was suggested that with changes in social attitudes to screening in pregnancy between the 1960s and now, that access to urinary tract infection treatment prevents the development of pyelonephritis at the high rates seen in the 1960s [5].…”