Asymptomatic bacteriuria in pregnancy and feto-meternal outcome

Background: Asymptomatic bacteriuria (ASB) is common in pregnancy; its prevalence varies between communities and different ethnicities and countries and has been implicated in adverse pregnancy outcomes. Thus, the present study determined the prevalence of ASB in pregnant women; to study the commonest causative pathogenic and antimicrobial susceptibility pattern, to assess the affliction of bacteriuria with age, parity, and socioeconomic status; and the effect of screening and treatment of ASB on maternal and fetal outcome. Methods: This was a prospective case-control study involving pregnant women attending the department of obstetrics and gynecology, Jawaharlal Nehru hospital and research Center, Bhilai (C. G.) over a period of 18 months (June 2022 to December 2023). A total of 140 pregnant women were divided into two groups: cases (n=70 patients with ASB) and controls (n=70 patients without ASB). Cases received 7 days course of antimicrobial drugs. Repeat cultures were obtained at 2 weeks and 4 weeks interval to detect any relapses till delivery. At similar intervals, women without bacteriuria were followed up and assessed for bacteriuria throughout the pregnancy till delivery. Results: The prevalence of ASB was 8.28%. On the first urine culture, E. coli (68.57%) was the most common organism grown and amikacin (30%) was the most sensitive antibiotic. The cases and controls did not differ significantly in any of the parameters, except significantly greater proportion of cases than controls had premature rupture of membranes (PROM) (p=0.003), underwent emergency lower segment caesarean section (LSCS) (p=0.049), a NICU stay of 6-10 days (p=0.001), and longer mean NICU stay (p<0.0001), while significantly greater proportion of controls than cases underwent normal vaginal delivery (p=0.007) and a NICU stay of 1-5 days (p=0.010). Conclusions: The overall prevalence of ASB was 8.28%. Even with treatment, the patients with ASB had a significantly higher risk of PROM, underwent emergency LSCS, and longer NICU stay.