Prevalence and Microbiological Profile of Urinary Tract Infection among pregnant women with Preeclampsia and Normotensive : A Retrospective Comparative Study

Abstract

Background:
Urinary tract infection (UTI) is one of the most prevalent bacterial infections in pregnancy and considered as asa for adverse maternal outcomes including hypertensive disorders of pregnancy. The relationship of UTI with pre-eclampsia is unclear, especially in Indian tertiary care settings. Objectives: To determine the prevalence of UTI among women with preeclampsia and normotensive pregnancy and to characterize microbiological profiles of urinary pathogens along with associated factors among those infected.

Methods:
A retrospective comparative cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Saveetha Medical College and Hospitals, Chennai. This retrospective study evaluated medical records of 60 pregnant women, including 30 patients with preeclampsia and 30 normotensive pregnant women. A structured proforma was used to extract data from antenatal case records, laboratory reports and urine culture registers. UTI was defined by significant growth on urine culture. Statistical analysis was carried out using the chi-square test, odds ratio (OR) with 95% confidence interval (CI), and binary logistic regression analysis.

Results:
The overall prevalence of culture-confirmed urinary tract infection was 38.3%, (23/60) among the 60 pregnant women included in the study. Urinary tract infection was found to be more frequent in women with preeclampsia compared to normotensive pregnant women, ,it is detected in 16 (53.3%) participants and seven (23.3%), respectively (χ² = 5.71, p = 0.017). Preeclamptic women exhibited an almost four-fold increased risk of urinary tract infection compared to normotensive pregnant women (OR = 3.76; 95% CI: 1.22–11.58). In multivariable binary logistic regression analysis, preeclampsia remained an independent predictor of urinary tract infection after adjusting for maternal age, gravidity and gestational age (Adjusted OR = 3.42; 95% CI: 1.06–11.03; p = 0.039). The microbiological assessment showed that the most common urinary pathogen was Escherichia coli (43.5% of isolates), followed by Klebsiella pneumoniae (26.1%) and Enterococcus faecalis (13.0%).

Conclusion:
The prevalence of UTI was significantly higher in women with preeclampsia than that in normotensive pregnant women. Colonization of UTIs remained an contributing risk factor for preeclampsia and emphasizes the need for routine urine culture screening to be performed when testing for microbiological evaluation in pregnant women with hypertensive disorders so that they can be diagnosed and treated early.