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Urinary tract infections in pregnancy.
Yveline Ansaldi1, Begoña Martinez de Tejada Weber2
1Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Summary
Urinary tract infections (UTIs) in pregnant women require careful management. While screening for asymptomatic bacteriuria (ASB) is recommended, further research is needed on its complications and optimal treatment strategies.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Pharmacology
Background:
- Urinary tract infections (UTIs) are common in pregnancy, posing risks to both mother and fetus.
- Physiological changes during pregnancy increase UTI susceptibility, affecting 2-15% of women.
- Asymptomatic bacteriuria (ASB) affects 2-7% of pregnant women, with ongoing debate regarding screening and treatment benefits.
Purpose of the Study:
- To review the pathophysiology, risk factors, and management of UTIs in pregnancy.
- To evaluate the impact of UTIs on pregnancy outcomes.
- To provide recommendations for optimal antimicrobial use during pregnancy.
Main Methods:
- A narrative review of literature.
- Searches conducted in PubMed, Cochrane database, and ClinicalTrials.gov.
Main Results:
- Low-to-moderate evidence suggests ASB treatment reduces low birth weight and preterm birth, supporting first-trimester screening.
- Recommended treatments for ASB include short courses of beta-lactams, nitrofurantoin, or fosfomycin.
- Acute pyelonephritis is linked to maternal complications, preterm delivery, and low birth weight; preferred treatments involve amoxicillin with an aminoglycoside, cephalosporins, or carbapenems.
Conclusions:
- Further research is essential to clarify ASB-related complications and the benefits of screening and treatment.
- More studies are needed to explore effective prophylactic measures for recurrent UTIs in pregnancy.
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