Maternal Urinary Tract Infection and Risk of Preeclampsia: A Cross Sectional Comparative Study

Abstract

Objective: To predict the risk of pre-eclampsia in patients with urinary tract infection during pregnancy.

Methodology: Pregnant women aged >15 years (N-300) were recruited and followed up prospectively from the start of prenatal care till the end of delivery. This cross sectional comparative study was conducted at CMH Kharian and PNS shifa Karachi from July 2020 to July 2021. A structured questionnaire was filled regarding medical and obstetric history, socio-demographic details and symptoms of urinary tract infection (UTI). Maternal mid-stream urine samples were obtained at 4 visits during pregnancy and were plated on MacConkey agar, later colony count was done. Logistic regression was used to find the risk of preeclampsia.

Results: Among 300 patients, 20 (6.6%) patients were diagnosed with UTI and 40 (13.3%) with preeclampsia. A statistically significant difference (p<0.05) was noticed between the pregnant females with UTI and without UTI regarding age, BMI, preeclampsia, hypertension, gestational diabetes, education, and gestational age. Patients with UTI during pregnancy showed an increased risk of preeclampsia in females with BMI 25 vs 30 (OR-1.25;95%CI-3.22-39.19) and BMI>30.0 (OR-5.61;95% CI-1.92-16.42), current preeclampsia (OR-0.322;95% CI-0.116-0.896), chronic hypertension (OR 0.318; 95% CI,0.124-0.82, p-0.018), nulliparous (OR-4.058;95% CI-1.32-12.44), current gestational diabetes (OR-0.231;95% CI-0.076-0.70) and in illiterate females (OR-0.064;95% CI-0.023-0.18). UTI during pregnancy was associated with a 3–4 fold increase in the risk of developing preeclampsia during the second trimester (OR-2.11; 95% CI-0.651–6.83) and third trimester (OR-4.12; 95% CI-1.28–13.19) compared to women who did not have UTI.

Conclusion: Presence of UTI in pregnancy is strongly associated with preeclampsia