Risk Factors for Asymptomatic Bacteriuria in Pregnant Women

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Chompilas Chongsomchi
Ekachai Piansriwatchara
Pisake Lumbiganon
Keskaew Pianthaweechi

Abstract

Background : Routine  urine  culture  for  all  pregnant  women  is  recommended as  the  screening  test  for  asymptomatic  bacteriuria  (ABU).  The  is  not  readily available  in many  parts  of  the  world  including  Thailand.  Identification  of  the  pregnant  women  at  higher  risk  for  ABU  and  performing  urine  culture  to  detect  ABU  may  be  the  appropriate  alternative  management.

Objective : To  asses risk  factors  for  asymptomatic  bacteriuria  (ABU)  in  pregnant  women.

Design: A  cross-sectional   study.

Setting  : A tertiary care (university)  hospital  in Thailand.

Subjects : 774 pregnant women  who attended  their  first  antenatal  care  at  Srinagarind  hospital,  Khon  Kaen University  were recruited  for  the  study,  Clean-catched  mid  stream  urine  were  obtained  from  every  subject  for  culture.

Main  outcome  measures : Information  regarding  sociodemographic  characteristics, obstetric history, history of previous urinary tract infection, the status of the present pregnancy and the result of urine  culture  were recorded. Risk factors  for ABU  were  initially  evaluated  by  univariate  analysis.  We  used  multiple  logistic  regression  analysis  for  controlling  confounding  effect.

Results : The  prevalence  of  ABU  in  pregnant  women  was  11.2%.  After univariate  and  multiple  logistic  regression  analysis,  anemia  and  low  education   were  found  to  be  significant  risk  factors  for  ABU  in  pregnant  women.  Anemic  pregnant  women had  a  2.5 fold  risk  of  having  ABU  compared  with  the  non-anemic  pregnant  women. Low  educated  pregnant  women  had a 1.7 fold  risk  of  ABU  compared  with  educated  subjects.  Age, occupation, monthly  income,  gravidity,  gestational  age,  previous  history  of  urinary  tract  infection  were  not  statistically associated  with  ABU.

Conclustions : Selective  urine  culture  for  anemic  or  low  educated  pregnant  women  may  be  considered  in  situation in  which  routine  urine  culture  for  pregnant  women  is  not  feasible.  A  sensitive  but  inexpensive  routine  screening  test  is  required  to  detect  ABU in  pregnant  women.

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