Abstract
Objective Urinary tract infection (UTI) is the most common bacterial infections during pregnancy. It is associated with different maternal and neonatal adverse outcomes such as low birth weight, preterm birth, still birth, preeclampsia, maternal anemia, sepsis, and amnionitis, even when the infection is asymptomatic. However, in Ethiopia, it is represented with fragmented and inconclusive pocket studies. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence of UTI and its associated factors among pregnant women in Ethiopia. Methods PubMed/Medline, Embase, Cochrane Library, Google Scholar, and local sources were used to access eligible studies. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was applied for critical appraisal. Heterogeneity and publication bias were evaluated using I2 statistic, funnel plot asymmetry, and Egger's tests. Random effect model was employed to estimate the pooled burden of UTI and its associated factors among pregnant women with its corresponding odds ratio (OR) and 95% confidence interval (CI). Result From all systematically searched articles, 14 studies were eligible for this analysis. The overall pooled prevalence of UTI among pregnant women in Ethiopia was 15.37% (95% CI: 12.54, 18.19). Family monthly income (OR = 3.8 and 95% CI: 1.29, 11.23), parity (OR = 1.59 and 95% CI: 1.01, 2.50), history of catheterization (OR = 2.76 and 95% CI: 1.31, 5.84), and history of UTI (OR = 3.12 and 95% CI: 1.74, 5.60) were factors significantly associated with UTI among pregnant women in Ethiopia. Conclusion The overall pooled estimate of UTI among pregnant women in Ethiopia was higher compared with CDC estimation which was 8%. Family monthly income < 1000ETB, multipara, previous history of catheterization, and history of UTI were factors increased burden of UTI during pregnancy. So, strategies targeting in economic reforms, universal access of family planning, and standardized prenatal care service should be addressed to alleviate this high prevalence of UTI during pregnancy.
Highlights
The likelihood of urinary tract infections (UTIs) is increased during pregnancy due to numerous women’s physiological changes [1]
This review revealed that the odds of UTI among pregnant women who had previous history of catheterization were higher than their counterparts
The overall pooled estimate of UTI among pregnant women in Ethiopia was higher than Communicable Disease Control (CDC) estimation which was 8%
Summary
The likelihood of urinary tract infections (UTIs) is increased during pregnancy due to numerous women’s physiological changes [1]. Pregnant patients are considered immunocompromised UTI hosts because of the physiologic changes associated. BioMed Research International with pregnancy [4]. These changes increase the risk of serious infectious complications from symptomatic and asymptomatic urinary infections even in healthy pregnant women [5]. It is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic [6]. Even though maternal UTI has few direct fetal sequelae because fetal bloodstream infection is rare, uterine hypoperfusion due to maternal dehydration, maternal anemia, and direct bacterial endotoxin damage to the placental vasculature may cause fetal cerebral hypoperfusion [7]
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