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妊娠期尿路感染及其对孕产妇和围产期结局的影响:一项回顾性研究

Urinary Tract Infection in Pregnancy and Its Effects on Maternal and Perinatal Outcome: A Retrospective Study.

作者信息

Balachandran Lekshmi, Jacob Leena, Al Awadhi Reem, Yahya Lamia O, Catroon Khlood M, Soundararajan Lakshmi P, Wani Saleema, Alabadla Sara, Hussein Yassmin A

机构信息

Obstetrics and Gynecology, Corniche Hospital, Abu Dhabi, ARE.

Pharmacology and Therapeutics, Corniche Hospital, Abu Dhabi, ARE.

出版信息

Cureus. 2022 Jan 22;14(1):e21500. doi: 10.7759/cureus.21500. eCollection 2022 Jan.

Abstract

Background A urinary tract infection (UTI) is a common medical condition complicating pregnancy with adverse maternal and perinatal outcomes. This study aimed to assess any adverse maternal and perinatal morbidity related to UTI in pregnancy, focusing on identifying common uropathogens and their antibiotic sensitivity and resistance patterns. Methods We conducted a retrospective cohort study at Corniche Hospital, Abu Dhabi. The study population consisted of 549 women in the exposed group (i.e., those with at least one episode of UTI in pregnancy in 2018) and 329 in the comparison group (i.e., those without UTI). Statistical analysis was done using SPSS Statistics for Windows, Version 19.0 (SPSS Inc., Chicago, IL). The study's primary outcome measures were preterm birth, recurrent UTI, pyelonephritis, and low birth weight (LBW). Results Women who had a UTI during pregnancy had more preterm deliveries than those without a UTI (c2=7.092; p=0.007). Recurrent UTI was observed in 26.6% of women with UTI, while the incidence of pyelonephritis was relatively low in this group (1.45%). There was no significant association between LBW and UTI in pregnancy (c=0.097; p=0.756). The most common bacteria isolated from women with UTI were Group B Streptococcus (GBS, 31.3%), followed by (30.9%). They were sensitive to a wide range of antibiotics. Conclusion According to our results, significant predictors of bacteriuria in pregnancy history include UTI, renal calculi, and nulliparity. Women with UTI in pregnancy are more likely to have preterm delivery. However, adequate management can minimize other complications like pyelonephritis and adverse perinatal outcomes. Available evidence prompts the recommendation of routine screening for asymptomatic bacteriuria (ASB) in early pregnancy to minimize complications and identify those women at significant risk for preterm delivery.

摘要

背景

尿路感染(UTI)是一种常见的孕期并发症,会导致不良的母婴和围产期结局。本研究旨在评估孕期UTI相关的任何不良母婴和围产期发病率,重点是确定常见的尿路病原体及其抗生素敏感性和耐药模式。方法:我们在阿布扎比的滨海医院进行了一项回顾性队列研究。研究人群包括暴露组的549名女性(即2018年孕期至少有一次UTI发作的女性)和对照组的329名女性(即无UTI的女性)。使用SPSS Statistics for Windows 19.0版(SPSS公司,伊利诺伊州芝加哥)进行统计分析。该研究的主要结局指标为早产、复发性UTI、肾盂肾炎和低出生体重(LBW)。结果:孕期发生UTI的女性比未发生UTI的女性早产更多(c2=7.092;p=0.007)。26.6%的UTI女性出现复发性UTI,而该组肾盂肾炎的发病率相对较低(1.45%)。孕期LBW与UTI之间无显著关联(c=0.097;p=0.756)。从UTI女性中分离出的最常见细菌是B族链球菌(GBS,31.3%),其次是(30.9%)。它们对多种抗生素敏感。结论:根据我们的结果,孕期菌尿的重要预测因素包括UTI、肾结石和未生育。孕期UTI的女性更有可能早产。然而,适当的管理可以将肾盂肾炎等其他并发症和不良围产期结局降至最低。现有证据促使建议在孕早期对无症状菌尿(ASB)进行常规筛查,以尽量减少并发症并识别出有早产高风险的女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/8860729/e370c5fb200f/cureus-0014-00000021500-i01.jpg

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