title: Asymptomatic bacteriuria in pregestational diabetic pregnancies and the role of group B streptococcus.
abstract: We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A (1c) values compared with diabetics without ASB (8.31 +/- 1.89 versus 7.31 +/- 1.84, P = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, HIMA/San Pablo Hospital, Caguas, Puerto Rico.
authors.forename: Jesus R
authors.initials: JR
authors.lastname: Alvarez
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Fechner
authors.forename: Shauna F
authors.initials: SF
authors.lastname: Williams
authors.forename: Vijaya L
authors.initials: VL
authors.lastname: Ganesh
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Apuzzio
mesh_terms: D000328:Adult; D001437:Bacteriuria / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D055815:Young Adult