Asymptomatic Bacteriuria and Its Associated Fetomaternal Outcomes among Pregnant Women Delivering at Bugando Medical Centre in Mwanza, Tanzania
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TextPublisher number: Wurzburg Road 35, BMC Premises, Post Code: 33102 : P. O. Box 1464, Mwanza – Tanzania :Phone: +255 28 298 3384 :Fax: +255 28 298 3386 : Email: vc@bugando.ac.tz :www.bugando.ac.tzLanguage: English Publication details: Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : 2023Description: 94 Pages; Includes References and AppendiciesSubject(s): Summary: Abstract:
Background: Asymptomatic bacteriuria (ASB) occurs in 2 to 15% of pregnant women globally, and if left untreated can be associated with adverse fetomaternal outcomes. The prevalence of ASB at Bugando Medical Centre (BMC) over the past decade is 13% to 17%, but it’s associated fetomaternal outcomes has not been evaluated to expedite preventive measures.
Methods: An analytical cross-sectional study involving 1,093 pregnant women admitted and planned for delivery at BMC was conducted. Sociodemographic and clinical characteristics, and mid-stream urine were collected for analyses. Concurrently, fetomaternal outcomes were assessed within 72 hours after delivery. Data were analyzed using STATA software version 15.0 using descriptive analyses and logistic regression analysis.
Results: The median age of enrolled participants was 29 years [range: 15-45 years]. The proportion of pregnant women with ASB was 16.9% (185/1093) and was predicted by having anaemia (OR 5.0; 95% CI 3.8-8, p-value <0.001) and history of admission during antenatal care (ANC) period (OR 4.3; 95% CI 3.1-6.1, p-value <0.001). Of all the enrolled patients 82 (7.51%), 65 (5.95%), 49 (4.49%) and 79 (7.23%) had pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with Low birth weight (LBW), respectively. The respective proportions among 185 patients with culture positive were 25.41%, 17.3%, 9.19% and 12.43%. On multivariate logistic regression analysis, PTL (OR 8.5; 95% CI 5.3-13.6, p-value <0.001); PROM (OR 5.5; 95% CI 3.3-9.3, p-value <0.001), preeclampsia (OR 2.8; 95% CI 1.5-5, p-value <0.001) and low birthweight (LBW), OR 2; 95% CI 1.2-3.7, p-value <0.011 were significantly associated with adverse fetomaternal outcomes. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) predominated, and their resistance to cephalosporins, amoxicillinclavulanate and nitrofurantoin which are safe drugs in pregnancy were low (range: 8.2% to 31.0%).
Conclusion: The prevalence of ASB among pregnant women is still high and is associated with adverse fetomaternal outcomes. This paves the way towards routine urine culture screening for high-risk pregnant women irrespective of their symptoms and provision of specific antimicrobial therapies so as to prevent adverse pregnancy outcomes.
| Item type | Current library | Collection | Status | Barcode | |
|---|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | NFIC | 1 | CUHAS/MMED/6000407/T |
Abstract:
Background: Asymptomatic bacteriuria (ASB) occurs in 2 to 15% of pregnant women globally, and if left untreated can be associated with adverse fetomaternal outcomes. The prevalence of ASB at Bugando Medical Centre (BMC) over the past decade is 13% to 17%, but it’s associated fetomaternal outcomes has not been evaluated to expedite preventive measures.
Methods: An analytical cross-sectional study involving 1,093 pregnant women admitted and planned for delivery at BMC was conducted. Sociodemographic and clinical characteristics, and mid-stream urine were collected for analyses. Concurrently, fetomaternal outcomes were assessed within 72 hours after delivery. Data were analyzed using STATA software version 15.0 using descriptive analyses and logistic regression analysis.
Results: The median age of enrolled participants was 29 years [range: 15-45 years]. The proportion of pregnant women with ASB was 16.9% (185/1093) and was predicted by having anaemia (OR 5.0; 95% CI 3.8-8, p-value <0.001) and history of admission during antenatal care (ANC) period (OR 4.3; 95% CI 3.1-6.1, p-value <0.001). Of all the enrolled patients 82 (7.51%), 65 (5.95%), 49 (4.49%) and 79 (7.23%) had pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with Low birth weight (LBW), respectively. The respective proportions among 185 patients with culture positive were 25.41%, 17.3%, 9.19% and 12.43%. On multivariate logistic regression analysis, PTL (OR 8.5; 95% CI 5.3-13.6, p-value <0.001); PROM (OR 5.5; 95% CI 3.3-9.3, p-value <0.001), preeclampsia (OR 2.8; 95% CI 1.5-5, p-value <0.001) and low birthweight (LBW), OR 2; 95% CI 1.2-3.7, p-value <0.011 were significantly associated with adverse fetomaternal outcomes. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) predominated, and their resistance to cephalosporins, amoxicillinclavulanate and nitrofurantoin which are safe drugs in pregnancy were low (range: 8.2% to 31.0%).
Conclusion: The prevalence of ASB among pregnant women is still high and is associated with adverse fetomaternal outcomes. This paves the way towards routine urine culture screening for high-risk pregnant women irrespective of their symptoms and provision of specific antimicrobial therapies so as to prevent adverse pregnancy outcomes.
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