Urinary Tract Infections In Antenatal Women: A Prospective Observational Study Of Their Association With Preterm Labor And Fetal Complications
DOI:
https://doi.org/10.63682/jns.v14i32S.8095Keywords:
N\AAbstract
Background: Urinary tract infections (UTIs) are common in pregnancy and pose significant maternal and fetal risks, including preterm labor and adverse neonatal outcomes. This study aimed to assess the association between UTIs in antenatal women and the incidence of preterm labor and fetal complications.
Methods: A prospective observational study was conducted over 12 months at Karpaga Vinayaga Institute of Medical Sciences & Research Centre, involving 200 antenatal women between 12 and 37 weeks of gestation. Participants were screened for UTIs using clean-catch midstream urine samples, followed by culture and sensitivity testing. Clinical and obstetric parameters were recorded, and maternal and neonatal outcomes were compared between UTI-positive and UTI-negative groups.
Results: Of the 200 participants, 70 (35%) were diagnosed with UTIs, predominantly caused by Escherichia coli (58.6%). UTI-positive women had significantly higher rates of preterm labor (35.7% vs. 13.8%, p=0.001), PPROM (17.1% vs. 5.4%, p=0.015), and lower mean gestational age at delivery (36.1 ± 1.8 weeks vs. 37.6 ± 1.2 weeks, p=0.003). Neonatal complications were also more frequent in this group, including low birth weight (28.6% vs. 13.8%, p=0.008), NICU admissions (20% vs. 6.9%, p=0.01), and neonatal sepsis (8.6% vs. 2.3%, p=0.04).
Conclusion: UTIs in pregnancy are significantly associated with increased risk of preterm labor and adverse neonatal outcomes. Routine screening and early antimicrobial treatment of both symptomatic and asymptomatic bacteriuria are essential strategies to improve perinatal health outcomes.
Downloads
Metrics
References
American College of Obstetricians and Gynecologists (ACOG). Urinary tract infections in pregnant individuals. Clinical Consensus. ACOG; August 2023.
Wang E, Tang P, Chen C. Urinary tract infections and risk of preterm birth: a systematic review and meta-analysis. Rev Inst Med Trop Sao Paulo. 2024 Sep 6;66:e54. doi: 10.1590/S1678-9946202466054. PMID: 39258657; PMCID: PMC11385076.
Palupi RI, Dewi IA, Rahmawati N. Effect of urinary tract infection on premature birth: a meta-analysis. J Matern Child Health. 2022;6(5):600–611. doi:10.26911/thejmch.2021.06.05.10.
Ifrah AA, Ishimwe MPS, Cedeño CAB, Hakizimana T. Susceptibility profile and associated factors of urinary tract infections among women with established preterm labor delivering at a tertiary teaching hospital in Eastern Uganda. BMC Pregnancy Childbirth. 2025;25(1):72. doi:10.1186/s12884-025-07215-w.
Romero R, Espinoza J, Gotsch F, Kusanovic JP, Friel L, Hassan S. The use of high-dimensional biology and systems biology to understand the biology of preterm birth. BJOG. 2006;113(Suppl 3):118–135.
Erku DA, Aemro A, Tsegaye AT, Belayneh F, Desta M, Tizazu MA, et al. Risk factors for neonatal sepsis among neonates in Ethiopia: a case–control study. Front Pediatr. 2023;11:1092671. doi:10.3389/fped.2023.1092671.
Al-Elwiya Pediatric Hospital Study. Maternal urinary tract infection as a risk factor for early-onset neonatal sepsis among Iraqi women. Baghdad Med J. 2024;66(1):45–51.
Keerthana PRL, Shalini GB, Prasanthi M, Tirupati S. Effect of asymptomatic bacteriuria on maternal-fetal outcomes. Research Journal of Medical Sciences. 2024;18(12):446–450.
Romero R, Oyarzun E, Mazor M, Sirtori M, Hobbins JC, Bracken M. Meta-analysis of the relationship between asymptomatic bacteriuria and preterm delivery/low birth weight. Obstet Gynecol. 1989 Apr;73(4):576–82. PMID: 2643358.
American College of Obstetricians and Gynecologists (ACOG). Urinary tract infections in pregnant individuals. ACOG Clinical Consensus No. 1. Obstet Gynecol. 2023 Aug;142(2):e58–e72. doi:10.1097/AOG.0000000000005264.
Goldenberg RL, Culhane JF. Infection-related preterm birth: pathogenesis and interventions. Maternal–Fetal Medicine Review. 2025;37(1):15–27. doi:10.1017/S096553952500001X.
Angulo Zamudio UA, Flores Villaseñor H, Leon Sicairos N, Zazueta Armenta D, Martínez Villa FA, Tapia Pastrana G, Angulo Rocha J, Murillo Llanes J, Barajas Olivas MF, Canizalez Roman A, et al. Virulence associated genes and antimicrobial resistance patterns in bacteria isolated from pregnant and nonpregnant women with urinary tract infections: the risk of neonatal sepsis. Can J Microbiol. 2023 Dec 1;69(12):488–500. doi:10.1139/cjm-2023-0046. PMID:37815047.
Yismaw AE, Fenta DA, Taye BW. Maternal risk factors for neonatal sepsis among neonates admitted to neonatal intensive care units at public hospitals in Hawassa City, Ethiopia: Unmatched case–control study. Ethiop J Health Sci. 2019 Jan;29(1):67–76. doi:10.4314/ejhs.v29i1.9. PMID: 30607044; PMCID: PMC6314535.
Piazzolla HRW, Modin F, Halkjær SI, Petersen AM, Calum H, Holm A. The association between bacteriuria and adverse pregnancy outcomes: a systematic review and meta-analysis of observational studies. J Antimicrob Chemother. 2024 Feb 1;79(2):241–254. doi:10.1093/jac/dkad374. PMID:38073146.
Werter DE, Kazemier BM, Schneeberger C, Mol BWJ, de Groot CJM, Geerlings SE, et al. Risk indicators for urinary tract infections in low risk pregnancy and the subsequent risk of preterm birth. Antibiotics (Basel). 2021;10(9):1055. doi:10.3390/antibiotics10091055.
Mirna Abde, Nina Weis, Anette Kjærbye Thygesen, Ellen Moseholm. Association between asymptomatic bacteriuria in pregnancy and adverse pregnancy- and birth outcomes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2024 Nov;302:116–124. doi:10.1016/j.ejogrb.2024.09.001. PMID: 39255721.
Weldegebriel MA, Fite RO, Asefa AD. Asymptomatic bacteriuria and its associated fetomaternal outcomes. PLoS One. 2024;19(3):e0303772. doi:10.1371/journal.pone.0303772.
Mazor-Dray E, Levy A, Schlaeffer F, Sheiner E. Urinary tract infections during pregnancy and the risk of preterm birth: a population-based study. Am J Obstet Gynecol. 2023 May;228(5):12.e1–12.e8. doi:10.1016/j.ajog.2023.01.012. PMID: 36758735.
Rahman E, Islam MR, Sultana R, Tasnim T, Hossain MA. Determination of the antibiotic susceptibility pattern of Gram-positive bacteria causing urinary tract infection in Dhaka, Bangladesh. arXiv [Preprint]. 2023 Jun 18; arXiv:2306.10553. Available from: https://arxiv.org/abs/2306.10553
Sharma A, Rawat A, Verma N, Taneja N. Antibiotic resistant profile of asymptomatic bacteriuria in pregnant women: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2020 Aug;18(8):823–833. doi:10.1080/14787210.2020.1791731.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
