Abstract
OBJECTIVE:
To identify predictors of symptomatic urinary tract infection (UTI) after 20 weeks’ gestation.
STUDY DESIGN:
A retrospective cohort analysis was conducted of all deliveries at three North Carolina hospitals between 1990 and 1993. A total of 7403 deliveries remained after exclusions (pre-pregnancy diabetes, HIV-positive, structural urologic abnormalities, no prenatal care) and restrictions (black or white race, county of residence). Cystitis and pyelonephritis were identified by clinician diagnosis. Multiple logistic regression was conducted.
RESULTS:
Prior UTIs (both before and earlier in pregnancy), nonprivate clinics, and a history of chlamydia (white women only) doubled the risk of symptomatic UTIs after 20 weeks’ gestation. The strongest predictor of pyelonephritis was prior antenatal UTIs (adjusted incidence odds ratio = 5.3, 95% confidence interval of 2.6–11.0), followed by less education (<12 years), a history of chlamydia, nonprivate clinics, illicit drug use, sickle cell hemoglobinopathy, and being unmarried.
CONCLUSION: Medical history and demographic factors predict cystitis and pyelonephritis after 20 weeks’ gestation. Prospective studies of pyelonephritis predictors and screening strategies are warranted.
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This work was financially supported by grant number R03 HS08901 fromthe Agency for Health Care Policy and Research, by a dissertation grantfrom the University of North Carolina at Chapel Hill Graduate School,and by National Institute of Child Health and Human DevelopmentCarolina Population Center training grant 2-T32-HD07168-16.
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Pastore, L., Savitz, D., Thorp, J. et al. Predictors of Symptomatic Urinary Tract Infection After 20 Weeks’ Gestation. J Perinatol 19, 488–493 (1999). https://doi.org/10.1038/sj.jp.7200264
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DOI: https://doi.org/10.1038/sj.jp.7200264
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