TITLE:
Uropathogens of Urinary Tract Infection in Pregnancy and Maternal-Fetal Outcomes at the Douala Referral Hospital, Cameroon: A Case-Control Study
AUTHORS:
Thomas Obinchemti Egbe, Njimanted Omarine, Essome Henri, Wague Wague Christiane Dayas Francine, Doretta Nzele Egbe, George Enonchong Enow-Orock
KEYWORDS:
Escherichia coli, Urinary tract Infection, Maternal-Fetal Outcomes, Neonatal Infection, Neonatal Intensive Care
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.7,
July
20,
2020
ABSTRACT: Background: Urinary tract infection (UTI) is common in pregnancy and accounts for a
high burden of maternal and perinatal morbidity/mortality and health expenditure. The burden of this condition
has been understudied in Cameroon. We aimed to determine the uropathogens
of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI
at the Douala Referral Hospital. Methods: We conducted an analytic matched case-control study of 206 pregnant women with evidence of urinary tract infection (103 cases) and those without (103 controls) who
underwent antenatal care and gave birth at the
DRH from January 2019 to April 2019. Socio-demographic, laboratory and maternal-fetal outcome data were collected using a
pre-tested structured questionnaire and analyzed with SPSS version 23.
Statistical significance was set at p Results: Escherichia coli (51.5%), Proteus mirabilis (15.5%), Staphylococcus aureus (11.7%) and Klebsiella sp. (6.8%) were the predominant uropathogens of UTI.
Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1; 95% CI: 1.11 -
3.55, p = 0.0023), preterm labor (AOR 4.4; 95% CI: 1.0 - 2.7, p = 0.008) and
preterm birth (AOR 4.6; 95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth
weight (AOR 2.1; 95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13; 95%
CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;
95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. Conclusion: Escherichia coli was the main
uropathogenic agent of UTI during
pregnancy. Maternal outcomes of UTI were puerperal pyelonephritis, preterm labor and delivery while
fetal outcomes include: low-birth weight, neonatal infection and
neonatal intensive care admission. Prompt diagnosis of this condition is the
cornerstone to avoid adverse outcomes.