Incidence and Predictors of Preeclampsia Among Pregnant Women With Urinary Tract Infection: A Prospective Observational Study

TL;DR

This study found that urinary tract infections during pregnancy are linked to a higher risk of preeclampsia, especially when infections are confirmed by culture or occur in late pregnancy.

Contribution

The study identifies specific clinical and microbiological predictors of preeclampsia among pregnant women with UTI.

Findings

Preeclampsia occurred in 12.3% of pregnant women with UTI.

Culture-positive UTI, third-trimester UTI, and higher BMI were independent predictors of preeclampsia.

Symptomatic UTI and lower educational status were also associated with increased preeclampsia risk.

Abstract

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections during pregnancy and has been implicated as a potential risk factor for adverse maternal and perinatal outcomes, including preeclampsia (PE). PE remains a leading cause of maternal and perinatal morbidity and mortality, particularly in developing countries. Increasing evidence suggests that maternal infection and systemic inflammation may contribute to the pathogenesis of PE, warranting further evaluation of the association between UTI during pregnancy and subsequent development of PE. The study aimed to determine the incidence and identify clinical and microbiological predictors of PE among pregnant women diagnosed with UTI.

Materials and methods: This prospective observational study was conducted over 18 months at Shri B.M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura. Pregnant women in any trimester diagnosed with UTI based on clinical features and/or laboratory criteria were enrolled and followed prospectively for the development of PE. Detailed demographic, obstetric, clinical, and laboratory data were collected. UTI was assessed using urine microscopy and culture, while PE was diagnosed according to standard guidelines. Statistical analysis included descriptive statistics, chi-square test for categorical variables, and binary logistic regression to identify predictors of PE within the cohort.

Results: Among 146 pregnant women with UTI, PE developed in 18 (12.3%), representing the incidence of PE within this cohort. Culture-positive infection, higher urine pus cell counts, and UTI diagnosed during the third trimester were significantly associated with the occurrence of PE within the study population (p < 0.05). PE was more frequent among women with increased body mass index, primigravida, and advanced maternal age. On multivariate logistic regression analysis, symptomatic UTI, culture-positive UTI, third-trimester UTI, elevated body mass index, primigravida, and lower educational status emerged as independent predictors of PE.

Conclusion: UTI during pregnancy, particularly when culture positive or occurring in late gestation, was significantly associated with the occurrence of PE within this cohort. However, in the absence of a comparison group without UTI, these findings identify predictors of PE among women with UTI rather than establishing UTI as an independent risk factor. Routine antenatal screening and appropriate management of UTI may help improve maternal monitoring and early identification of hypertensive complications, especially in resource-limited settings.