The study shows that ABU is not
associated with preterm birth in
with an uncomplicated pregnancy with a single baby. The study
also found that the risk of developing pyelonephritis or
kidney infection in pregnant patients
with ABU is very low.
Asymptomatic bacteriuria is a common
condition in which a significant number of bacteria are present in the urine
but there are no symptoms of infection.
ABU affects about 5 to 10% pregnant
women, according to the World Health Organization Reproductive Health Library.
Health experts say, this infection can
progress in pregnant women, causing acute infection and inflammation of other
parts of the urinary tract including the urethra, bladder and the kidneys.
Kidney infection or pyelonephritis, in turn, can lead to complications such as
preterm birth and death of newborn babies.
Therefore, screening for ABU and
subsequent treatment for positive patients is usually recommended for
midtrimester - pregnant women at 12 to 16 weeks' gestation.
Researchers at the Department of
Obstetrics and Gynecology, Academic Medical Center, Amsterdam, Netherlands,
studied the consequences of treated and untreated ABU in pregnancy, noting that
the current methods for the screening and treatment for ABU are based on
studies and trials that were conducted more three decades ago.
new trial, researchers enrolled as many as 5621 women with a singleton pregnancy (or normal pregnancy with one baby) between 16
and 22 weeks' gestation from eight hospitals and five ultrasound centers into the screening.
these, 4283 women were finally included in the study, out of which 248 were ABU
ABU positive patients, 40 were randomly assigned to nitrofurantoin - an antibiotic used to treat urinary
- and 45 to placebo. The other 163 ABU-positive participants were
followed without treatment.
Researchers compared untreated and
placebo-treated ABU-positive participants with ABU-negative participants and
nitrofurantoin-treated ABU-positive participants.
The study showed that kidney infection,
preterm birth, or both did not differ significantly among the ABU positive
patients not treated with antibiotic, and the ABU negative patients. The
difference was also not noted between the antibiotic treated patients, and
placebo treated or untreated ABU positive patients. This implies that treatment
with antibiotic does not make much of a difference in preventing preterm birth,
kidney infection or both in patients with ABU.
Pyelonephritis was found more often among
women who were ABU positive but not treated with antibiotic than among
ABU-negative women, but this absolute risk was considerably low.
However, further studies are required
before the current recommendations of treating asymptomatic bacteruria
can be considered for revision. The study was funded by ZonMw, the Netherlands
Organization for Health Research and Development.
Kazemier BM et al.
Maternal and neonatal consequences of treated and untreated asymptomatic
bacteriuria in pregnancy: a prospective cohort study with an embedded
randomised controlled trial. DOI: http://dx.doi.org/10.1016/S1473-3099(15)00070-5