Abstract
Symptomatic urinary tract infections are associated with preterm birth. However, data on risk indicators for urinary tract infections are limited and outdated. The research is a secondary analysis. The study was a prospective multicenter cohort study of low-risk pregnant women. Logistic regression was used to identify risk indicators for urinary tract infections. The incidence of urinary tract infections was 9.4%. Multivariate logistic regression showed that a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria in the present pregnancy were associated with urinary tract infections (resp. OR 3.14, 95%CI 1.40–7.02 and OR 1.96 95%CI 1.27–3.03). Women with a urinary tract infection were at increased risk of preterm birth compared to women without a urinary tract infection (12 vs. 5.1%; adjusted HR 2.5 95%CI 1.8–3.5). This increased risk was not found in women with the identified risk indicators (resp. 5.3% vs. 5.1%, adjusted HR 0.35 95%CI 0.00–420 and adjusted HR 1.5 95CI% 0.59–3.9). In conclusion, in low-risk pregnant women, risk indicators for urinary tract infections are: a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria. The risk of preterm birth is increased in women with a urinary tract infection in this pregnancy. However, women with recurrent urinary tract infections and asymptomatic bacteriuria this pregnancy appear not to be at increased risk of preterm birth.
Highlights
Preterm birth is the leading cause of perinatal mortality and morbidity [1,2]
We found that risk indicators independently associated with urinary tract infection (UTI) during pregnancy were a history of recurrent UTI and the presence of asymptomatic bacteriuria (ASB)
We found a trend towards a lower preterm birth rate in women with a UTI during the present pregnancy and a history of recurrent UTI
Summary
Preterm birth is the leading cause of perinatal mortality and morbidity [1,2]. Preterm birth is directly responsible for the death of around one million neonates worldwide every year and is known to cause long-term neurologic and developmental disabilities [2,3,4]. Symptomatic urinary tract infection (UTI) in pregnancy is associated with preterm birth [5,6,7]. Previous research has shown that the incidence of UTI during pregnancy varies between 2.3% and 15% [6,8,9]. Since prevention of UTI may be helpful in preventing preterm birth, identification of women who are more prone to develop a UTI is required
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