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

Abstract

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.

A study of urinary tract infection in pregnancy and its effect on maternal and perinatal outcome

“…In our study, UTI in pregnancy is more common in primigravida patients (19 patients=56%), followed by second gravida patients (9 patients=26%) and 6 cases in multigravida patients (18%), this is similar to Amit et al study which showed 60% of primigravida having UTI in pregnancy and Mahor et al study. 3,6 In our study, highest cases ( 60%) of UTI were observed in second trimester of pregnancy, followed by in third trimester in 10 patients ( 31%), and the lowest incidence was found in the first trimester (9%), which is similar to Mahor et al study. 6 This difference may be as a result of either change in urinary stasis and vesicoureteral reflux or decrease in urinary progesterone and estrogens in the various trimester of pregnancy.…”

“…3,6 In our study, highest cases ( 60%) of UTI were observed in second trimester of pregnancy, followed by in third trimester in 10 patients ( 31%), and the lowest incidence was found in the first trimester (9%), which is similar to Mahor et al study. 6 This difference may be as a result of either change in urinary stasis and vesicoureteral reflux or decrease in urinary progesterone and estrogens in the various trimester of pregnancy. 18 Most of the studies found that the incidence of UTI was highest in second trimester.…”

“…This is similar to Esha et al study and Mahor et al study. 1,6 This is probably because, most of the patients had their pregnancy and marriages during this age group. Also, highest prevalence in this age group could be due to the fact that many are sexually active in this age group.…”

“…This is due to difference in the socio-economic levels and standards of living. [6][7][8][9] If asymptomatic bacteriuria is not treated, approximately 25% of women will subsequently develop acute symptoms of an infection during pregnancy. 1 Symptomatic and asymptomatic bacteriuria have been reported among 17.9% and 13% pregnant women respectively.…”

“…In the fetus, it can cause intra uterine growth restriction, prematurity and low birth weight and the perinatal death. 6 Thus, screening for UTI should be a part of routine antenatal care, so that early detection and treatment of asymptomatic bacteriuria prevents the maternal and fetal complications.…”