DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180081

Prevalence of asymptomatic bacteriuria among antenatal women and its effects on maternal and perinatal outcome in northern Andhra Pradesh population

Prabhavathi V., Krishnamma B., Krishna Murthy G., Prasad DKV

Abstract


Background: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than non-pregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome.

Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey’s agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes.

Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; 1.37-5.88, p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively).

Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.


Keywords


ASB, LBW, Pregnancy, Perinatal outcome, PTL, Preeclampsia

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References


Gilbert DN, Moelleving RC Jr, Eliopoulos GN, Sande NA. Sanford guide to antimicrobial therapy. 32nd ed. Hyde Park, Vermont: Antimicrob Therapy, Inc. 2005:22-23.

Chandel LR, Kanga A, Thakur K, Mokta KK, Sood A, Chauhan S. Prevalence of pregnancy associated asymptomatic bacteriuria: A study done in a tertiary care hospital. J Obst Gyn Ind. 2012;62(5):511-4.

Girish Babu RJ, Srikrishna R, Ramesh ST. Asymptomatic bacteriuria in pregnancy. Int J Biol Med Res. 2011;2(3):740-2.

Amiri M, Lavasani Z, Norouzirad R, Najibpour R, Mohamapour M, Nikpoor AR, et al. Prevalence of urinary tract infection among pregnant women and its complications in their newborns during the birth in the hospitals of Dezful city, Iran, 2012-2013. Iran Red Crescent Med J. 2015;17(8):e26946.

Bacak SJ, Callaghan WM, Dietz PM, Crouse C. Pregnancy-associated hospitalizations in the United States, 1999-2000. Am J Obstet Gynecol. 2005;192:592-7.

Ezechi OC, Gab-Okafor CV, Oladele DA, Kalejaiye OO, Oke BO, Ekama SO, et al. Prevalence and risk factors of asymptomatic bacteriuria among pregnant Nigerians infected with HIV. J Matern Fetal Neonatal Med. 2013;26:402-6.

Ajayi AB, Nwabuisi C, Aboyeji AP, Ajayi NS, Fowotade A, Fakeye OO. Asymptomatic bacteriuria in antenatal patients in Ilorin, Nigeria. Oman Med J. 2012;27:31-35.

Nicolle LE. Asymptomatic bacteriuria. Curr Opin Infect Dis. 2014;27(1):90-6.

Nicolle LE, Capuano G, Ways K, Usiskin K. Effect of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, on bacteriuria and urinary tract infection in subjects with type 2 diabetes enrolled in a 12-week, phase 2 study. Cur Med Res Opin. 2012;28:1167-71.

Hooton TM, Gupta K. Urinary tract infections and asymptomatic bacteriuria in pregnancy. In: Basow DS, editor. UpToDate. Waltham, MA: UpToDate; 2010.

Enayat K, Fariba F, Bahram N. Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran. Int Braz J Urol. 2008;34(6):699-707.

Harris RE. The significance of eradication of bacteriuria during pregnancy. Obstet Gynecol. 1979;53:71-3.

Kerure RD, Umashanker. Prevalence of asymptomatic bacteriuria among pregnant women in a tertiary care hospital. IJSRP. 2013;3(11):2250-3.

Verma A, Baheti S, Sharma M. Asymptomatic bacteriuria in pregnancy and its relation to perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5:4390-6.

Imade PE, Izekor PE, Eghafona NO, Enabulele OI, Ophori E. Asymptomatic bacteriuria among pregnant women. N Am J Med Sci. 2010;2(6):263-6.

Amadi ES, Enemuo OB, Uneke CJ, Nwosu OK, Onyeagba RA, Ugbogu OC. Asymptomatic bacteriuria among pregnant women in Abakaliki, Ebonyi State, Nigeria. J Med Sci. 2007;7(4):698-700.

Sudha BK, Rajeshwari S, Sheela SS, Sneha H. Asymptomatic bacteriuria among pregnant women. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):213-6.

Prasanna B, Naimisha M, Swathi K, Shaik MV. Prevalence of asymptomatic bacteriuria in pregnant women, isolates and their culture sensitivity pattern. Int J Curr Microbiol App Sci. 2015;4(8):28-35.

Okonko IO, Ijandipe LA, Ilusanya AO, Donbraye- Emmanuel OB. Detection of urinary tract infection (UTI) among pregnant women in Oluyoro Catholic Hospital, Ibadan, South-Western Nigeria. Malays J Microbiol. 2010;6(1):16-24.

Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JC, Dolin R, editors. Mandell, Douglas, and Bennett’s: Principles and Practice of Infectious Disease. 7. Elsevier; PA, USA;2010:957-85.

Gayathree L, Shetty S, Deshpande SR, Venkatesha DT. Screening for asymptomatic bacteriuria in pregnancy: An evaluation of various screening tests in Hassan District hospital, India. J Clin Diagn Res. 2010;4(4):2702-6.

Sheiner E, Mazor E, Levy A. Asymptomatic bacteriuria during pregnancy. J Matern Fetal Neonat Med. 2009;22:423-7.

Gravett MG, Rubens CE, Nunes TM; GAPPS Review Group. Global report on preterm birth and stillbirth (2 of 7): discovery science. BMC Pregnancy Childbirth. 2010;10(Suppl.1):S2:1-26.

Smaill F, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2007;CD000490.

Jain V, Das V, Agarwal A, Pandey A. Asymptomatic bacteriuria and obstetric outcome following treatment in early versus late pregnancy in north Indian women. Ind J Med Res. 2013;137(4):753-8.

Prio TK, Bruunsgaard H, Roge B, Pedersen BK. Asymptomatic bacteriuria in elderly humans is associated with increased levels of circulating TNF receptors and elevated numbers of neutrophils. Exp Gerontol. 2002;37:693-9.

Minassian C, Thomas SL, Williams DJ, Campbell O, Smeeth L. Auto maternal infection and risk of preeclampsia: a population based case-control study. PLOS One. 2013;8:e73047.

Radha S, Nambisan B, Prabhakaran NK, Jamal S. Prevalence and outcome of asymptomatic bacteriuria in early pregnancy. Int J Reprod Contracept Obstet Gynecol. 2017;6:223-7.

Herrera JA, Chaudhuri G, Lopez-Jaramillo P. Is infection a major risk factor for preeclampsia? Med Hypotheses. 2001;57:393-7.

Vaishali J, Vinita D, Anjoo A, Amita P. Asymptomatic bacteriuria and obstetric outcome following treatment in early versus late pregnancy in north Indian women. Indian J Med Res. 2013;137(4):753-8.

Farkash E, Wientraub AY, Sergienko R, Wiznitzer A, Zlotnik A, Sheiner E. Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and outcomes. Eur J Obstet Gynecol Reprod Biol. 2012;162:24-7.

McIsaac W, Carrol JC, Biringer A, Bernstein P, Lyons E, Low DE, et al. Screening for asymptomatic bacteriuria in pregnancy. J Obstet Gynaecol Can. 2005;27:20-4.

Tugrul S, Oral O, Kumru P, Köse D, Alkan A, Yildirim G. Evaluation and importance of asymptomatic bacteriuria in pregnancy. Clin Exp Obst Gynecol. 2005;32(4):237-40.