Prevalence and outcome of asymptomatic bacteriuria in early pregnancy


  • Sreekumary Radha Department of Obstetrics and Gynecology, Medical College, Trivandrum, Kerala, India
  • Bindu Nambisan Department of Obstetrics and Gynecology, Medical College, Trivandrum, Kerala, India
  • Nisha Kizhekkepurakkal Prabhakaran Department of Obstetrics and Gynecology, Medical College, Trivandrum, Kerala, India
  • Shahida Jamal Department of Obstetrics and Gynecology, Medical College, Trivandrum, Kerala, India



Asymptomatic bacteriuria, Pyelonephritis, Urine microscopy, Urine culture


Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of the urinary tract. The primary objective was to find out the prevalence of asymptomatic bacteriuria in pregnancies less than 28 weeks gestation in our hospital and to study the various adverse pregnancy outcomes in the study group.

Methods: This was a cross sectional study done over a period of 12 months at this tertiary care centre in Government sector in Trivandrum, Kerala. A sample size was calculated statistically and 400 women with gestational age less than 28 weeks attending the outpatient department were included in this study. A structured proforma, urine microscopy and urine culture and sensitivity were the study tools.

Results: Prevalence of asymptomatic bacteriuria in our study population was 8.25%. Commonest pathogen isolated was E.coli in 57.14% cases. Maternal morbidity was higher in women with asymptomatic bacteriuria (24.2%) than those without (12.5%). Fetal morbidity in women with asymptomatic bacteriuria was 24% whereas it was 12.5% in those without it. Preterm labour, preeclampsia and prematurity were the common morbidities noted.

Conclusions: Since pregnant women with asymptomatic bacteriuria were at an increased risk of adverse maternal and fetal outcome, routine screening for asymptomatic bacteriuria preferably in the first trimester is highly recommended.


Lavanya SV, Jogalakshmi D Asymptomatic bacteriuria in antenatal women. Indian J Med Micribiol. 2002;20:105-6.

DeIzell JE, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician. 2000;61(3):713-21.

Kass EH. Asymtomatic infections in urinary tract. Trans Assoc Am Physicians. 1956;69:56-64.

Fathima N, Yasmin S, Ishrat S. Prevalence and complications of asymtomatic bacteriuria during pregnancy: Professional Med J. 2006;13(1):108-12.

Nerissa Isabel C, Carla Elena J. Prevalence of Asymptomatic Bacteriuria and Associated Risk Factors in Pregnant Women. Phil J Microbiol Infect Dis. 2003;32(2):63-9.

Jayalaxmi J, Jayaram VS. Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women: IJPM. 2008;51(3):379-81.

Selassie S. Asymptomatic bacteriuria in pregnancy: epidemiological, clinical and microbiological approach. Ehiop Med J. 1998;36(3):185-92.

Whalley P. Bacteriuria of pregnancy. Am J Obstet Gynecol. 1967;97:723-38.

Haider G. Risk factors of urinary tract infection in pregnancy. J Pak Med Assoc. 2010;62(3):213-6.

Mittendorf R. Prevention of preterm delivery and low birth weight associated with asymtomatic bacteriuria. Clin Infec Dis. 1992;14(4):927-32.

Romero R, Oyarzane E. Meta analysis of relationship between asymtomatic bacteriuria and preterm delivery/low birth weight. Obstetrics and Gynaecology. 1989;73:576-82.

Abyad A. Screening for asymptomatic bacteriuria in pregnancy urinalysis versus urine culture. J Fam Pract. 1991;33(5):471-4.

Patterson TF, Andriole VT. Bacteriuria in pregnancy. Infect Disclin North Arm 1987;1:807-22.

Macejko AM, Schaeffer AJ. Asymptomatic bacteriuria and symptomatic UTI in pregnancy. Urol Clin North Am. 2007;34(1):35-42.

Hazhir S. ABU in pregnant women Uro J. 2007;4(1):24-7.

Gupta K, Hillier SL, Hooton TM, Roberts PL, Stamm WE. Effects of contraceptive method on the vaginal microbial flora: a prospective evaluation. J Infect Dis. 2000;181:595-601.

Towers CV, Kaminskas CM, Garite TJ. Pulmonary injury associated with antepartum pyelonephritis: can patients at risk be identified? Am J Obstet Gynecol. 1991;164:974-8.

American Academy of Family Physicians. Summary of recommendations for clinical preventive services. Revision 6.4. August 2007.






Original Research Articles