Asymptomatic bacteriuria as a predictor of pre-eclampsia: A case-controlled study

Abstract

Background: Pre-eclampsia, an important cause of maternal and perinatal morbidity and mortality world-wide has been linked to  subclinical infections, with maternal infection and inflammation postulated in its aetio-pathogenesis including asymptomatic bacteriuria  which is common in pregnancy. The Obejctive of the study is to determine the relationship of asymptomatic bacteriuria as a risk factor for  pre-eclampsia.

Methodology: A hospital-based case-control study among 28 pre-eclamptic pregnant women (cases) and 56 healthy  pregnant women (controls) at gestational age of at least 28 weeks at the University College Hospital, Ibadan, between January 2019 and August 2019. Controls were matched with cases in age, parity and gestational age. Asymptomatic bacteriuria was determined with mid- stream urine analysis for microscopy and culture and data collected using an interviewer administered questionnaire with other details  from medical records extracts. Chi- square, and multivariate regression analysis were used to assess statistical significance, odds ratio  and adjusted odds ratio respectively, with P-value <0.05 and 95% confidence interval (CI).

Results: There was a significant association  between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was about three times higher in women with  pre-eclampsia compared to those without pre-eclampsia and 1.23 times higher after adjusting for confounders (OR: 2.9, AOR:1.23).  There was no significant relationship between sterile pyuria and pre-eclampsia (p-value: 0.92)

Conclusion: This study supports the  proposition that asymptomatic bacteriuria is a risk factor for pre-eclampsia. It has not however shown whether the association is causal  or casual. Further studies will be needed to explain this.