Journal
JOURNAL OF WOMENS HEALTH
Volume 30, Issue 11, Pages 1556-1564Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/jwh.2020.8946
Keywords
cystitis; pregnancy complications; pyelonephritis; socioeconomic factors; urinary tract infections
Categories
Funding
- Centers for Disease Control and Prevention (CDC) [96043, 02081, DD09-001, DD13003, DD18-001]
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This study investigated maternal characteristics associated with urinary tract infection (UTI) during pregnancy based on data from nearly 42,000 pregnant women. It found that besides diabetes, low educational attainment, low household income, and race/ethnicity were significantly associated with higher prevalence of UTI during pregnancy. The varying prevalence of UTI by geography and maternal characteristics could provide insights into the causes of UTI during pregnancy.
Background: Urinary tract infection (UTI) is the most common bacterial infection in pregnancy. Known risk factors for UTI in pregnancy include diabetes and certain urologic conditions. Other maternal characteristics might also be associated with risk and could provide clues to the etiology of UTI in pregnancy. Our objective was to identify maternal characteristics associated with UTI in pregnancy. Materials and Methods: We used data from pregnant women participating in the National Birth Defects Prevention Study, a population-based study of risk factors for major structural birth defects in 10 U.S. sites, from 1997 to 2011. In cross-sectional analyses, we used multivariable log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for associations between self-reported maternal characteristics and UTI in pregnancy. Results: In our sample of 41,869 women, the overall prevalence of reported UTI in pregnancy was 18%, but ranged from 11% to 26% between study sites. In adjusted models, diabetes was moderately associated with higher UTI prevalence (PR 1.39, 95% CI: 1.24-1.57). Higher UTI prevalence was associated even more strongly with low educational attainment (PR 2.06, 95% CI: 1.77-2.40 for some high school vs. graduate school), low household income (PR 1.64, 95% CI: 1.46-1.84 for <$10,000 vs. >=$50,000), and race/ethnicity (PR 1.45, 95% CI: 1.13-1.80 for American Indian or Alaska Native vs. White women). Conclusions: About one in six women reported UTI in pregnancy but the prevalence varied markedly by geography and maternal characteristics. This variability could provide clues to the causes of UTI in pregnancy.
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