Urinary Tract Infection and Fetal Outcomes Among Pregnant Women in Adare General Hospital, Hawassa, Ethiopia

Abstract

Background: Fetal complications can occur if pregnant women with urinary tract infection (UTI) are not treated. We aimed to determine the magnitude of UTI, drug resistance profile, and fetal outcomes among pregnant women in Adare General Hospital, Hawassa, Ethiopia. Methods: Facility-based cross-sectional study was conducted among 308 pregnant women using questionnaire and review of medical records. From 308 randomly selected pregnant women, clean catch midstream urine samples were collected, processed, and inoculated onto MacConkey and blood agars and after incubation, the colonies were further confirmed by using standard biochemical tests. A binary logistic regression model was used to compute the explanatory variables with the outcome variable. A p value less than 0.05 was considered statistically significant. Results: The overall prevalence of UTI was 13.6% with a 95% CI: 10-18. Out of 42 samples, 39 (92.8%) UTI infections in women between the ages of 15 and 34 were identified. The three most common bacterial isolates were Escherichia coli, Staphylococcus aureus, and Staphylococcus saprophyticus. The majority of the Gram-negative bacteria isolates were resistant to ampicillin (96.2%) and trimethoprim-sulfamethoxazole (39%), while the Gram-positive bacteria were resistant to tetracycline (75%) and trimethoprim-sulfamethoxazole (68.8%). Of the total 308 pregnant women who participated in the study, there were 51 (16.6%) poor fetal outcomes. In this study, the presence of bacteriuria had a significant association with poor fetal outcomes (p value = 0.001). The mother's age, gravidity, level of education, occupation, marital status, and previous UTI history were not associated with the current UTI status. Conclusions: Poor fetal outcomes are strongly associated with UTI during pregnancy. Early detection of UTI and treatment after culture and antibiotic susceptibility testing should be a priority for the management of UTIs in pregnancy to avoid poor fetal outcomes.

Keywords: UTI; drug resistant; poor fetal outcomes; pregnant women.