Urinary Tract Infections in Pregnant Populations

Urinary tract infections (UTIs) represent a leading bacterial complication in pregnancy, affecting both maternal well-being and foetal outcomes. Physiological and anatomical shifts—such as ureteric dilation, reduced bladder tone and increased urinary stasis—predispose expectant mothers to ascending infections. Both symptomatic UTIs and asymptomatic bacteriuria (ASB) can progress to pyelonephritis, preterm delivery and low birth weight if untreated. Common risk factors include prior UTI history, catheterisation and underlying metabolic conditions. Clinical presentation may overlap with normal gestational changes, making reliable diagnostics essential. While point-of-care dipstick testing offers rapid screening, urine culture remains the gold standard. Management hinges on selecting agents with proven safety profiles in pregnancy and tailoring therapy according to susceptibility patterns. The global rise in antimicrobial resistance underscores the need for judicious antibiotic stewardship, universal screening protocols in antenatal care and low-cost diagnostic innovations, particularly in resource-limited settings.

Research from Nature Portfolio

A cross-sectional study in a tertiary care centre examined the bacterial spectrum and resistance profiles among admitted gynaecological patients, many of whom were pregnant or peripartum. The overall UTI prevalence was around 25%, with Escherichia coli and Klebsiella species predominating. Alarmingly, nearly four in five isolates exhibited multidrug resistance, including extended-spectrum β-lactamase producers. Gram-negative pathogens showed high rates of ampicillin and tetracycline resistance, whereas nitrofurantoin retained full activity against Gram-positive uropathogens. The findings advocate routine urine culture and susceptibility testing in hospitalised obstetric patients to guide targeted therapy and curb the emergence of resistant strains.

Urinary Tract Infections in Pregnant Populations publication trend

The graph below shows the total number of articles in urinary tract infections in pregnant populations across all publications each year (not limited to Nature Index journals).

Technical terms

Asymptomatic bacteriuria (ASB): Presence of bacteria in the urine at significant colony counts without urinary symptoms.

Extended-spectrum β-lactamase (ESBL): Enzyme produced by certain bacteria that confers resistance to penicillins and cephalosporins.

Nitrofurantoin: An antimicrobial agent particularly effective against common uropathogens and considered safe in pregnancy.

Urine culture: Laboratory method for isolating and identifying urinary pathogens and determining their antibiotic susceptibilities.

References

1. Overuse of antibiotics for urinary tract infections in pregnant refugees, Lebanon. Bulletin of the World Health Organization (2024).
2. Real world drug treatment models for pregnancy complicated with urinary tract infection in China from 2018 to 2022: a cross-section analysis. Frontiers in Pharmacology (2024).
3. Diagnostic Accuracy of Urine Dipsticks for Urinary Tract Infection Diagnosis during Pregnancy: A Retrospective Cohort Study. Antibiotics (2024).
4. Uropathogenic bacterial profile and antibiotic susceptibility pattern of isolates among gynecological cases admitted to Jimma Medical Center, South West Ethiopia. Scientific Reports (2023).