title: Impact of trimester on morbidity of acute pyelonephritis in pregnancy.
abstract: OBJECTIVE
  We sought to compare maternal and neonatal morbidity as well as obstetric outcomes associated with pyelonephritis in pregnancy during the first compared to the second/third trimester.
  
  
  METHODS
  A retrospective cohort analysis was performed of all pregnant women admitted to a single tertiary care hospital between January 2004 and June 2007 with pyelonephritis. The primary outcome was length of hospitalization. The study had 80% power to detect a 1-day difference in length of stay.
  
  
  RESULTS
  In all, 219 cases of acute pyelonephritis were identified: 23 diagnosed in the first trimester and 196 in the second/third trimester. Women were hospitalized for a median of 4 days in both the first (range, 2-7) and second/third (range, 2-9; P = .6) trimesters. Neonatal and obstetric outcomes were not statistically significant.
  
  
  CONCLUSIONS
  Maternal morbidity and obstetric outcomes do not differ between first- and second-/third-trimester pyelonephritis. First-trimester pyelonephritis should be aggressively treated to prevent adverse outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Women & Infants Hospital, Brown University, Providence, RI, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Archabald
authors.forename: Alexander
authors.initials: A
authors.lastname: Friedman
authors.forename: Christina A
authors.initials: CA
authors.lastname: Raker
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Anderson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011704:Pyelonephritis; D012189:Retrospective Studies; D055815:Young Adult