Asymptomatic bacteriuria during pregnancy.
OBJECTIVE
The present study was aimed to test the association between asymptomatic bacteriuria during pregnancy, among patients in whom antibiotic treatment was recommended, and perinatal outcome. Our study was also designed to characterize common bacteria and risk factors associated with asymptomatic bacteriuria during pregnancy.


METHODS
A retrospective population-based study comparing all singleton pregnancies of women with and asymptomatic bacteriuria was conducted. Patients with urinary tract infection were excluded from the analysis. Multiple logistic regression model was used to control for confounders.


RESULTS
Out of 199,093 deliveries, 2.5% (n = 4890) were in patients with asymptomatic bacteriuria. E. coli was the most common pathogen associated with asymptomatic bacteriuria, representing 78.6% of the cultures with specified growth. Patients with asymptomatic bacteriuria were more likely to deliver preterm (PTD, 13.3%vs. 7.6%, odd ratio (OR) = 1.9, 95% confidence interval CI 1.7-2.0; P < 0.001) and deliver low birth-weight neonates (<2500 g, 13.3%vs. 7.9%, OR = 1.8; 95% CI 1.6-2.0; P < 0.001). Asymptomatic bacteriuria was independently associated with PTD (adjusted OR = 1.6; 95% CI 1.5-1.7; P < 0.001), fertility treatments, hypertensive disorders, recurrent abortions, diabetes mellitus, intrauterine growth restriction, polyhydramnion and oligohydramnion, premature rupture of membranes and labour induction, in a multivariable analysis with backwards elimination. Perinatal mortality rates (1.5%vs. 1.4%; P = 0.707) as well as low 5 min Apgar scores (0.8%vs. 0.6%; P = 0.065) were comparable between the groups.


CONCLUSIONS
Asymptomatic bacteriuria is an independent risk factor for preterm delivery.
Sheiner
Eyal
E
Faculty of Health Sciences, The Department of Obstetrics and Gynecology, Soroka University Medical Center, Be'er-Sheva, Israel. sheiner@bgu.ac.il
Mazor-Drey
Efrat
E
Levy
Amalia
A
D000328:Adult; D001437:Bacteriuria / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000652:urine; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D011512:Proteus Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D055815:Young Adult