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

Abstract

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.

The Association between Gestational Diabetes Mellitus and Infections in Pregnancy—Systematic Review and Meta-Analysis

“…Identifying gestational diabetes mellitus as a risk factor for maternal asymptomatic bacteriuria is important since it was associated with infectious disease of the offspring later in life. In a study that aimed to test the association between maternal asymptomatic bacteriuria during pregnancy and long term offspring infectious hospitalizations, it was found that asymptomatic bacteriuria during pregnancy increased offspring susceptibility to long-term infectious hospitalizations even after controlling for maternal age, diabetes mellitus, ethnicity, hypertensive disorders, and gestational age, thus, emphasizing the importance of screening high-risk populations for maternal asymptomatic bacteriuria, including women with gestational diabetes mellitus [ 62 ].…”

Asymptomatic bacteriuria in pregnant women: is antibiotic therapy always justified?

“…Долгосрочные последствия ББУ недостаточно изучены [33]. Был проведен популяционный когортный анализ, в ходе которого сравнивали частоту развития ИМП у потомства, рожденного от матерей, у которых во время беременности была диагностирована ББУ, и тех, у кого ББУ не было.…”

“…Проанализированы 212 984 истории родов. Среди всех беременных у 5378 (2,5%) была диагностирована ББУ; их дети чаще страдали ИМП [33]. Было установлено, что ИМП у беременной женщины представляет собой значительный фактор риска в отношении ИМП у ребенка: 30% против 6,8% [34].…”

Perinatal outcomes and long-term infectious morbidity of offspring born to mothers with familial Mediterranean fever

“…Fetal programming is the hypothesis that describes the interaction between the offspring's long-term health and its in-utero environmental conditions [10]. Studies have associated maternal exposures during pregnancy such as smoking, maternal obesity, and maternal urinary tract infection with long-term infectious morbidity of the offspring [10][11][12][13]. FMF is known to cause a pro-in ammatory state that increases the secretion of IL-1, IL-18, and other mediators of in ammation that enhance chemotaxis and neutrophilia, inducing an FMF are [14].…”