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Glob Adv Health Med. 2013 Sep;2(5):59-69. doi: 10.7453/gahmj.2013.061.

Urinary tract infection as a preventable cause of pregnancy complications: opportunities, challenges, and a global call to action.

Global advances in health and medicine

Nicole M Gilbert, Valerie P O'Brien, Scott Hultgren, George Macones, Warren G Lewis, Amanda L Lewis

Affiliations

  1. Department of Molecular Microbiology, Center for Women's Infectious Disease Research, Washington University School of Medicine, St Louis, Missouri, United States.
  2. Department of Obstetrics and Gynecology, Center for Women's Infectious Disease Research, Washington University School of Medicine, St Louis, Missouri, United States.
  3. Department of Medicine, Center for Women's Infectious Disease Research, Washington University School of Medicine, St Louis, Missouri, United States.
  4. Departments of Molecular Microbiology, Obstetrics and Gynecology, Center for Women's Infectious Disease Research, Washington University School of Medicine, St Louis, Missouri, United States.

PMID: 24416696 PMCID: PMC3833562 DOI: 10.7453/gahmj.2013.061

Abstract

The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in more developed countries. A global analysis of the etiologies of UTI revealed familiar culprits as well as emerging threats. Screening and treatment of UTI have improved birth outcomes in several more developed countries and would likely improve maternal and neonatal health worldwide. However, challenges of implementation in resource-poor settings must be overcome. We review the nature of the barriers occurring at each step of the screening and treatment pipeline and highlight steps necessary to overcome these obstacles. It is our hope that the information compiled here will increase awareness of the global significance of UTI in maternal and neonatal health and embolden governments, nongovernmental organizations, and researchers to do their part to make urine screening and UTI treatment a reality for all pregnant women.

Keywords: Urinary tract infection; complications; pregnancy; prevention; women's health

References

  1. J Coll Physicians Surg Pak. 2006 Apr;16(4):273-5 - PubMed
  2. Ann Saudi Med. 2002 Sep-Nov;22(5-6):333-5 - PubMed
  3. Fam Pract. 2003 Aug;20(4):410-2 - PubMed
  4. Lancet. 2006 Jun 3;367(9525):1835-41 - PubMed
  5. J Pak Med Assoc. 2010 Mar;60(3):213-6 - PubMed
  6. Ethiop Med J. 2010 Jan;48(1):11-21 - PubMed
  7. J Obstet Gynaecol East Cent Africa. 1983 Sep;2(3):108-12 - PubMed
  8. Afr J Reprod Health. 2005 Aug;9(2):118-24 - PubMed
  9. Eur J Clin Invest. 2008 Oct;38 Suppl 2:50-7 - PubMed
  10. PLoS One. 2012;7(3):e33897 - PubMed
  11. East Afr J Public Health. 2009 Aug;6(2):112-8 - PubMed
  12. Trop Doct. 1983 Jul;13(3):131-3 - PubMed
  13. Am Fam Physician. 2010 Feb 15;81(4):505 - PubMed
  14. J Paediatr Child Health. 2011 Jan;47(1-2):5-11 - PubMed
  15. Ann Intern Med. 1962 Jan;56:46-53 - PubMed
  16. West Afr J Med. 1993 Jan-Mar;12(1):27-33 - PubMed
  17. BMC Res Notes. 2012 Apr 25;5:197 - PubMed
  18. Afr Health Sci. 2010 Dec;10(4):349-52 - PubMed
  19. Clin Infect Dis. 2005 Mar 1;40(5):643-54 - PubMed
  20. BMC Pregnancy Childbirth. 2012 Jun 21;12:52 - PubMed
  21. Saudi Med J. 2009 Jul;30(7):917-20 - PubMed
  22. Arch Intern Med. 1960 Feb;105:194-8 - PubMed
  23. Ethiop J Health Sci. 2012 Jul;22(2):121-8 - PubMed
  24. Arch Gynecol Obstet. 2013 Jun;287(6):1137-49 - PubMed
  25. Nepal Med Coll J. 2007 Dec;9(4):266-9 - PubMed
  26. J Clin Diagn Res. 2012 Nov;6(9):1518-22 - PubMed
  27. Tanzan J Health Res. 2009 Jul;11(3):154-9 - PubMed
  28. Br J Biomed Sci. 2006;63(3):109-12 - PubMed
  29. Obstet Gynecol. 1989 Apr;73(4):576-82 - PubMed
  30. Jpn J Infect Dis. 2006 Aug;59(4):261-3 - PubMed
  31. West Indian Med J. 2007 Oct;56(5):414-20 - PubMed
  32. Womens Health Newsl. 1998 Mar;(36):5 - PubMed
  33. Oman Med J. 2012 Jan;27(1):31-5 - PubMed
  34. Indian J Pathol Microbiol. 2008 Jul-Sep;51(3):379-81 - PubMed
  35. J Health Popul Nutr. 2012 Jun;30(2):193-204 - PubMed
  36. Urol J. 2007 Winter;4(1):24-7 - PubMed
  37. ISRN Obstet Gynecol. 2011;2011:721872 - PubMed
  38. Public Health. 2005 Nov;119(11):1039-41 - PubMed
  39. Nig Q J Hosp Med. 2008 Apr-Jun;18(2):61-3 - PubMed
  40. Southeast Asian J Trop Med Public Health. 2002 Sep;33(3):575-80 - PubMed
  41. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD000490 - PubMed
  42. Int Braz J Urol. 2008 Nov-Dec;34(6):699-704; discussion 704-7 - PubMed
  43. Sex Transm Dis. 2011 Mar;38(3):167-71 - PubMed
  44. J Pak Med Assoc. 1994 Jan;44(1):12-3 - PubMed
  45. Arch Gynecol Obstet. 2012 Dec;286(6):1357-62 - PubMed
  46. East Mediterr Health J. 2000 Mar-May;6(2-3):265-71 - PubMed
  47. J Obstet Gynaecol. 2007 Apr;27(3):252-4 - PubMed
  48. Bangladesh Med Res Counc Bull. 1977 Dec;3(2):145-8 - PubMed
  49. Ethiop Med J. 2007 Apr;45(2):143-9 - PubMed
  50. Trop Med Health. 2011 Sep;39(3):73-6 - PubMed
  51. Indian J Community Med. 2010 Apr;35(2):285-9 - PubMed
  52. Clin Exp Obstet Gynecol. 2002;29(4):281-5 - PubMed
  53. East Mediterr Health J. 2005 May;11(3):505-10 - PubMed
  54. Matern Child Health J. 2009 Mar;13(2):198-205 - PubMed
  55. Ophthalmology. 2010 Aug;117(8):1500-5 - PubMed
  56. J Obstet Gynaecol. 2001 Mar;21(2):141-4 - PubMed
  57. Ann Clin Microbiol Antimicrob. 2011 Jan 18;10:2 - PubMed
  58. Health Care Women Int. 2003 Aug;24(7):635-49 - PubMed
  59. Am J Med. 2002 Jul 8;113 Suppl 1A:5S-13S - PubMed
  60. Niger J Clin Pract. 2010 Dec;13(4):409-12 - PubMed
  61. Ghana Med J. 2007 Mar;41(1):26-9 - PubMed
  62. Ethiop Med J. 2008 Jul;46(3):227-35 - PubMed
  63. Best Pract Res Clin Obstet Gynaecol. 2007 Jun;21(3):439-50 - PubMed
  64. Clin Exp Obstet Gynecol. 2005;32(4):237-40 - PubMed
  65. BMC Pregnancy Childbirth. 2010 Feb 23;10 Suppl 1:S3 - PubMed
  66. N Am J Med Sci. 2010 Jun;2(6):263-6 - PubMed
  67. BJOG. 2006 Jan;113(1):65-74 - PubMed
  68. Eur J Epidemiol. 2011 Jun;26(6):493-502 - PubMed
  69. Am J Obstet Gynecol. 1979 Dec 15;135(8):1066-70 - PubMed
  70. Am J Obstet Gynecol. 2003 Nov;189(5):1398-400 - PubMed
  71. Obstet Gynecol. 2000 Jun;95(6 Pt 1):899-904 - PubMed
  72. West Afr J Med. 2011 Mar-Apr;30(2):89-93 - PubMed
  73. Bangladesh Med Res Counc Bull. 2007 Aug;33(2):60-4 - PubMed
  74. J Obstet Gynaecol. 2012 Jan;32(1):37-41 - PubMed
  75. Lancet. 2005 Mar 12-18;365(9463):977-88 - PubMed
  76. PLoS Med. 2013;10(2):e1001396 - PubMed
  77. Afr J Med Med Sci. 2011 Dec;40(4):377-83 - PubMed
  78. Genitourin Med. 1992 Feb;68(1):39-41 - PubMed
  79. N Engl J Med. 2001 Aug 16;345(7):487-93 - PubMed
  80. Birth Defects Res A Clin Mol Teratol. 2008 Jun;82(6):464-73 - PubMed
  81. J Reprod Med. 2003 Aug;48(8):627-30 - PubMed
  82. Aust N Z J Obstet Gynaecol. 1999 Feb;39(1):50-4 - PubMed
  83. J Indian Med Assoc. 2005 May;103(5):259-62, 266 - PubMed
  84. Cochrane Database Syst Rev. 2001;(2):CD000490 - PubMed
  85. Ethiop Med J. 1998 Jul;36(3):185-92 - PubMed
  86. Niger J Med. 2010 Apr-Jun;19(2):188-93 - PubMed
  87. J Infect Dis. 1994 Jun;169(6):1390-2 - PubMed
  88. Scand J Infect Dis. 2005;37(4):262-8 - PubMed
  89. Clin Exp Obstet Gynecol. 1989;16(4):126-9 - PubMed
  90. Trop Geogr Med. 1971 Mar;23(1):113-4 - PubMed
  91. J Med Assoc Thai. 2009 May;92(5):606-10 - PubMed
  92. J Coll Physicians Surg Pak. 2006 Aug;16(8):514-7 - PubMed
  93. Rev Fr Gynecol Obstet. 1992 Jan;87(1):26-9 - PubMed
  94. Indian J Med Microbiol. 2002 Apr-Jun;20(2):105-6 - PubMed
  95. Arch Gynecol Obstet. 2012 Apr;285(4):913-7 - PubMed
  96. Obstet Gynecol. 2009 Feb;113(2 Pt 1):339-45 - PubMed
  97. Clin Infect Dis. 1996 Jun;22(6):1051-6 - PubMed
  98. BMJ. 2005 Nov 12;331(7525):1107 - PubMed

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