Prevalence and Factors Associated With Urogenital Bacterial Colonization Among Women With Preterm Labor at a Tertiary...

Urogenital bacterial colonization is common during pregnancy and is associated with preterm labor and preterm births. Physiological, hormonal, and immunological changes of pregnancy increase the susceptibility to colonization of the urogenital tract by pathogenic bacteria, which may contribute to adverse pregnancy outcomes. This study aimed to estimate the prevalence of urogenital bacterial colonization and identify factors associated with it among women with preterm labor at Mbarara Regional Referral Hospital.

This was a cross-sectional study involving 156 women with preterm labor who were consecutively enrolled between November 2022 and April 2023. Data on independent variables were collected using an interviewer-guided structured questionnaire. Urine samples and endocervical and high vaginal swabs were collected and processed for microbiological culture to detect bacterial colonization. We used modified Poisson regression to identify factors associated with bacterial colonization.

Out of the 156 women with preterm labor enrolled in this study, 85 (54.5%) had urogenital bacterial colonization. The mean age of the participants was 25.5 ± 5.77 years. Most of the participants were referred from other health facilities (n = 120, 76.9%) and had a history of abnormal vaginal discharge (n = 117, 75%). Factors independently associated with bacterial colonization included age <20 years (aPR 1.66, 95% CI: 1.23-2.25, p = 0.001) and abnormal vaginal discharge (aPR 1.79, 95% CI: 1.12-2.87, p = 0.016).

Urogenital bacterial colonization was common among women with preterm labor in southwestern Uganda. Younger maternal age (<20 years) and abnormal vaginal discharge were independently associated with urogenital bacterial colonization. These findings highlight the need for increased clinical suspicion and targeted evaluation of urogenital bacterial colonization, including microbiological culture and antibiotic susceptibility testing of urinary tract and genital tract specimens, particularly among pregnant women with preterm labor, who are at higher risk.