Prevalence of Asymptomatic Bacteriuria, Associated Risk Factors and Adverse Fetomaternal Outcome among Antenatal women attending a tertiary care hospital

Background: Asymptomatic bacteriuria is the commonest bacterial infection which require medical treatment in pregnancy. Untreated bacteriuria during pregnancy is associated with adverse perinatal outcomeslike prematurity & low birth weight babies and having a 20-40% increased risk of developing pyelonephritis during pregnancy when compared with women without bacteriuria. Aims: To determine the prevalence of asymptomatic bacteriuria among pregnant women attending antenatal OPD in Ganga Ram hospital, to identify risk factors that increases the risk of asymptomatic bacteriuria during pregnancy and to determine adverse maternal & perinatal outcome in the form of pyelonephritis, cystitis and low birth weight and preterm babies respectively. Setting: Ante-natal clinic at Gynae Outpatient department at Sir Ganga Ram Hospital, Lahore. Study Design: Cross-sectional descriptive Duration of Study: 6th December, 2004 to 6th June, 2005 Sample Size: 580 women were included in this study that fulfilled the criteria. Sampling Technique: Non-probability, purposive sampling Methods: Mid stream urine samples were collected from 580 asymptomatic women for asymptomatic bacteriuria over period of six months from 6th December, 2004 to 6th June, 2005 presenting at antenatal clinic of Gynae Outpatient department at Sir Ganga Ram Hospital, Lahore. All specimens were initially screened by dipstick method followed be CLED culture for those specimens which were positive for dipstick test. Primary outcome measures of the study were to determine prevalence of asymptomatic bacteriuria and adverse fetomaternal outcome in the form of preterm labor, low birth weight, cystitis and pyelonephritis respectively. Result: The prevalence of asymptomatic bacteriuria in this study was 4.6 %. Multiparty, low education level and low socio economic status were detected as risk factors having significant association with asymptomatic bacteriuria (p-<0.05). No significant adverse perinatal outcome were detected in the form of premature delivery and low birth weight (p->0.05). In group with bacteriuria 14.2% women developed cystitis as compare to non bacteriuria group in which only 2.8% developed cystitis (p<0.05) while none of the patient developed pyelonephritis. Conclusion : Screening for bacteriuria in pregnancy and proper treatment should be considered as an essential part of antenatal care. To prevent complications of asymptomatic bacteriuria all pregnant women should be screened at their first antenatal visit.