The Risk of Preterm Birth in Low Risk Pregnant Women with Urinary Tract Infections

Abstract

Objective Urinary tract infections are among the most common infections during pregnancy. The association between symptomatic lower urinary tract infections during pregnancy and fetal and maternal complications such as preterm birth and low birthweight remains unclear. The aim of this research is to evaluate the association between urinary tract infections during pregnancy and maternal and neonatal outcomes, especially preterm birth. Study Design This study is a secondary analysis of a multicenter prospective cohort study, which included patients between October 2011 and June 2013. The population consists of women with low risk singleton pregnancies. We divided the cohort into women with and without a symptomatic lower urinary tract infection after 20 weeks of gestation. Baseline characteristics and maternal and neonatal outcomes were compared between the two groups. Multivariable logistic regression analysis was used to correct for confounders. The main outcome was spontaneous preterm birth at <37 weeks. Results We identified 4,918 pregnant women eligible for enrollment, of whom 9.4% had a symptomatic lower urinary tract infection during their pregnancy. Women with symptomatic lower urinary tract infections were at increased risk for both preterm birth in general (12 vs. 5.1%, adjusted OR 2.5; 95% CI 1.7–3.5) as well as a spontaneous preterm birth at <37 weeks (8.2 vs. 3.7%, adjusted OR 2.3; 95% CI 1.5–3.5). This association was also present for early preterm birth at <34 weeks. Women with symptomatic lower urinary tract infections during pregnancy are also at increased risk of endometritis (8.9 vs. 1.8%, adjusted OR 5.3; 95% CI 1.4–20) and mastitis (7.8 vs. 1.8%, adjusted OR 4.0; 95% CI 1.6–10) postpartum. Conclusion Low risk women with symptomatic lower urinary tract infections during pregnancy are at increased risk of spontaneous preterm birth. In addition, an increased risk for endometritis and mastitis postpartum was found in women with symptomatic lower urinary tract infection during pregnancy. Key Points

Antibiotic use during pregnancy and the risk of preterm birth: a population-based Swedish cohort study

“…and preterm birth association cannot be assessed and confounding by indication, e.g. by urinary tract infections, 30 may play a role. Indication of drug use is not registered in relation to the prescription (and only specialist-outpatient diagnoses and hospital discharge diagnoses are available).…”

Maternal Prenatal Infections and Biliary Atresia in Offspring

“…It is also possible that having a premature immune system, along with dysregulated responses to infection or toxins, is a factor in progressive inflammation in the hepatobiliary system . Antepartum infectious diseases have been associated with preterm labor, which introduces the possibility of confounding bias in this study. To address this concern, we implemented the inverse probability weighting approach to balance the different distribution of potential confounders such as infant sex, gestational age, infant birth weight, and other maternal infectious diseases .…”

“…The exposure of interest was maternal infectious diseases during pregnancy, including intestinal infection, genitourinary tract infection, influenza, upper airway infection, pneumonia, and soft-tissue infection. 25 , 26 , 27 , 28 We defined these infections according to relevant ICD-9 or ICD-10 diagnostic codes used for at least 1 outpatient or inpatient claim in the NHIRD. 18 eTable 1 in Supplement 1 provides the relevant ICD-9 and ICD-10 diagnostic codes used to identify these diseases.…”

Pendidikan Kesehatan Menggunakan Video Edukatif terhadap Pencegahan Kegawatdaruratan Kehamilan Akibat Infeksi Saluran Kemih

“…berkembang yang berpenghasilan rendah. Penelitian sebelumnya menunjukkan bahwa kejadian ISK selama kehamilan bervariasi antara 2,3% dan 15% (6,8,9) (Werter et al, 2021;Lee et al, 2019).…”

“…Rahim membembesar, menekan kandung kemih, sehingga meningkatkan tekanan intravesika yang dapat menyebabkan refluks vesikoureteral dan retensi urine pada kandung kemih setelah buang air kecil. Stasis urine dan kerusakan mekanisme refluks fisiologis menimbulkan kondisi yang mendukung pertumbuhan bakteri dan infeksi ascending (Werter et al, 2021;Azami et al, 2019;Lee et al, 2019;Yan et al, 2018). Jika infeksi ini tidak diobati, dapat menyebabkan janin lahir dengan berat badan lahir rendah, retardasi pertumbuhan intrauterin, persalinan prematur dan bayi prematur, kematian janin intrauterin, dan peningkatan mortalitas dan morbiditas prenatal serta komplikasi ibu termasuk anemia, preeklamsia, gagal ginjal, septikemia, dan sindrom pernapasan dewasa (Ali et al, 2022).…”