bacteria in urine pregnancy

Urinary Tract Infection (UTI) In Pregnancy: Symptoms & Treatment

What is the problem?

Can give antibiotics to pregnant women who have a urinary tract infection but no symptoms improve outcomes for women and their babies?

Why is this important?

urine bacterial infection without the typical symptoms associated with urinary tract infection (asymptomatic bacteriuria) occurs in a number of (2% to 15%) of pregnancy. Because of the changes that occur in their bodies, pregnant women are more likely to develop a kidney infection (pyelonephritis) if they have a urinary tract infection. Infection can also cause babies born prematurely (before 37 weeks), or at a low birth weight (weight less than 2500 g (5.5 lb)).

What evidence do we find?

We found 15 randomized controlled studies involving more than 2,000 pregnant women with urinary tract infections, but there are no symptoms. Antibiotics may be effective in reducing the incidence of kidney infection in the mother (12 study of 2017 women) and clearing the infection from the urine (four studies, 596 women). They can also reduce the incidence of premature births (three studies, 327 women) and low birth weight infants (six studies, 1437 infants). No study assessed enough antibiotic treatment side effects for the mother or the baby, and often how the study was conducted are not explained well.

We assess three main results with the GRADE approach, and found evidence of low certainty that antibiotic treatment can prevent pyelonephritis, premature birth, and birth weight less than 2500 grams.

What's this mean?

antibiotic treatment can reduce the risk of kidney infection in pregnant women who have a urinary infection but no symptoms of infection. Antibiotics can also reduce the chances of the baby will be born too early or have a low birth weight. However, due to the low certainty of evidence, it is difficult to draw conclusions; further research is needed.

antibiotic treatment may be effective in reducing the risk of pyelonephritis in pregnancy, but the belief we estimate a limited effect given the low certainty of evidence. There may be a decrease in premature births and low birth weight with antibiotic treatment, consistent with theories about the role of infection in adverse pregnancy outcomes, but once again, the effect is limited confidence in the low certainty given the evidence.

implication studies identified in this review include the need for up-to-date evaluation of the cost effectiveness of diagnostic algorithm, and more evidence to determine whether there are low-risk group of women who are unlikely to benefit from treatment of asymptomatic bacteriuria ,

asymptomatic bacteriuria is urine bacterial infection without the typical symptoms associated with urinary tract infections, and occurs in 2% to 15% of pregnancies. If left untreated, up to 30% of mothers will develop acute pyelonephritis. asymptomatic bacteriuria has been associated with low birth weight and premature birth. This is an update of the last review was published in 2015.

To assess the effect of antibiotic treatment for asymptomatic bacteriuria on the development of pyelonephritis and the risk of low birth weight and premature birth.

for this update, we searched the Cochrane Pregnancy and Childbirth Trials Register ,, WHO International Clinical Trials Registry platform () on 4 November 2018, and reference lists of retrieved studies.

randomized controlled trials (RCTs) comparing antibiotics with placebo or no treatment in pregnant women with asymptomatic bacteriuria found on antenatal screening. The trial design uses a cluster-RCTs and quasi-RCTs were eligible for inclusion, such as the trial published in abstract form or letter, but did not cross-over study.

Two review authors independently rated trials for inclusion and risk of bias, retrieve data, and checked for accuracy. We assess the quality of evidence using the GRADE approach.

We included 15 studies, involving more than 2000 women. antibiotic treatment compared with placebo or no treatment can reduce the incidence of pyelonephritis (average risk ratio (RR) 0.24, 95% confidence interval (CI) from 0.13 to 0.41; 12 study of 2017 women; evidence of low certainty). Antibiotic treatment may be associated with decreased incidence of preterm birth (RR 0.34, 95% CI 0.13 to 0.88; 3 studies, 327 women; evidence of low certainty), and low birth weight babies(Average RR 0.64, 95% CI 0.45 to 0.93; 6 studies, 1437 infants; evidence of low certainty). There may be a reduction in persistent bacteriuria at the time of delivery (average RR 0.30, 95% CI 0.18 to 0.53; 4 trials; 596 women), but the results were inconclusive for serious adverse outcomes of neonatal (average RR 0.64, 95% CI 0.23 to 1.79, 3 studies; 549 infants). There are data to estimate the effect of antibiotics on the results of other babies, and mothers rarely described side effects are very limited

Overall, we rated only one low-risk trial bias in all domains .; 14 Another study assessed as high risk or not obviously biased. Many studies do not have an adequate description of the methods, and we can only assess the risk of bias as obvious, but in many studies, we assess at least one domain at high risk of bias. We assess the quality of evidence for three primary outcomes with software GRADE, and found evidence of low certainty for pyelonephritis, premature birth, and birth weight less than 2500 grams.

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