The Peezy Device Compared With Midstream Clean Catch in an Obstetric Population: A Randomized Controlled Trial

Screening for asymptomatic bacteriuria in pregnancy is part of routine prenatal care, as untreated bacteriuria can lead to acute pyelonephritis and adverse pregnancy outcomes. The standard clean catch midstream urine collection method can be difficult to obtain, and often results in contamination, particularly in patients with obesity. The Peezy urine collection device, designed to discard the initial voided urine, has shown promise in reducing contamination rates compared with the conventional clean catch method but has not been studied in the pregnant population.

This study aims to compare the rates of contamination in urine cultures collected before 20 weeks' gestation between the clean catch midstream urine sample and the Peezy urine sample.

This randomized controlled trial at the Loyola University Medical Center enrolled adult English-speaking women presenting for prenatal care at an academic clinic from August 2022 to January 2024. Patients were excluded if they had urinary tract anomalies, ongoing antibiotic treatment, or recurrent urinary tract infections. Participants were randomized to either Peezy or clean catch urine collection methods. We compared the contamination rates of urine specimens collected using the Peezy collection device versus the standard midstream clean catch method in pregnant women using an intention-to-treat analysis. We also assessed whether the effect of the Peezy device on contamination rates varied by body mass index (BMI) status (nonobese vs. obese participants).

Overall (n = 218), the contamination rate was 61.3% (n = 73/119) for control participants and 52.5% (n = 52/99) for Peezy participants (odds ratio = 0.7, 95% confidence interval: 0.4-1.2; p = 0.19) and was not different between groups, even when stratified by BMI.

This study did not show any reduction in contamination among participants using the Peezy.

· This study is a randomized controlled trial between Peezy and standard clean catch.. · Ours is the first study of Peezy in a pregnant population.. · We found no difference in urine contamination rates..