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

Abstract

OBJECTIVES. The effects of antepartum urinary tract infection on adverse maternal and perinatal outcomes were examined. Antepartum urinary tract infection has been previously implicated as a risk factor for numerous outcomes. METHODS. Crude and multivariable analyses were performed with a perinatal registry cohort of 25,746 mother/infant pairs. RESULTS. Elevated risks were observed for exposure to urinary tract infection and low birthweight, prematurity, preterm low birthweight, premature labor, hypertension/preeclampsia, maternal anemia, and amnionitis. Urinary tract infection was associated with perinatal death only among subjects 20 to 29 years of age. CONCLUSIONS. These findings underscore the importance of antepartum urine screening to identify patients at risk for adverse outcomes.

Urinary Tract Infections During Pregnancy

“…This condition can occur with or without symptoms of cystitis. Overall, pyelonephritis is associated with worse maternal and prenatal prognosis (Schieve et al, 1994). Clinical signs and symptoms of pyelonephritis include flank pain (unilateral or bilateral) or abdominal pain, fever, anorexia, nausea and vomiting often associated with variable degrees of dehydration, chills, headache, and tachypinea.…”

“…Other maternal complications that have been associated with UTIs during pregnancy are hypertension and preeclampsia (Conde-Agudelo et al, 2008;Rustveld et al, 2008), anemia (Fede, 1983), chorioamnionitis and endometritis (Schieve et al, 1994;Delzell & Lefevre, 2000). The causal nature of these associations is questionable, because it is not always clear whether an episode of UTI preceded the particular outcome of interest, especially in what concerns maternal hypertension and anemia (Schieve et al, 1994).…”

“…The causal nature of these associations is questionable, because it is not always clear whether an episode of UTI preceded the particular outcome of interest, especially in what concerns maternal hypertension and anemia (Schieve et al, 1994). The relationship between UTIs during pregnancy and preeclampsia is consistent throughout studies performed over the last years, and is present in diverse settings worldwide (CondeAgudelo et al, 2008).…”

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

“…For example, our study found that trimethoprim/sulfamethoxazole is the most frequently used antibiotics in pregnancy. While antibiotics during pregnancy are often needed (for example, for urinary tract infection), 18 the use of trimethoprim/sulfamethoxazole could be avoided because it is not the only choice of antibiotics for urinary tract infection; there are alternative antibiotics with equal effects. 19 Trimethoprim/sulfamethoxazole is a folic acid antagonist that may cause birth defects and other adverse outcomes in the infants.…”

Anemia in pregnancy in rural Tanzania: associations with micronutrients status and infections

“…In a previous study, we showed that urinary tract infections were very common in this setting (Olsen et al, 2000), and should be given more attention at antenatal visits. Apart from the association with anemia, urinary tract infections in pregnancy increase the risk of pyelonephritis, amnionitis, premature labor, low birth weight and perinatal death (Schieve et al, 1994), and deserves more attention at antenatal clinics (Carroli et al, 2001). …”