Urinary Tract Infection among Pregnant Women and Diabetic Patients: A Systematic Review

Diabetes mellitus (DM) is one of the most common noncommunicable diseases, affecting the health of a large proportion of the global population. The presence of fasting blood glucose levels greater than 126 mg/dL is a key symptom of diabetes mellitus.

Urinary tract infections are associated with considerable morbidity in both the mother and the baby during pregnancy. The combination of mechanical, hormonal, and physiological changes that occur during pregnancy causes significant changes in the urinary system that have a considerable impact on the acquisition of bacteriuria and its natural history. Infections of the urinary tract during pregnancy can result in poor pregnancy outcomes and complications such as preterm delivery, low birth weight, preeclampsia (toxaemia), and anaemia. Therefore, it is important to check and treated as soon as possible.

The identification of the types of organisms that cause urinary tract infections in diabetes mellitus (DM) and pregnant women (PW) patients, as well as the selection of an effective antibiotic against the organism in question, is critical to the successful care of these individuals. The rise of resistant bacterial strains in hospitals continues to represent a problem in terms of the treatment and control of disease transmission. Furthermore, the indiscriminate use of antibiotics often leads to an increase in resistant urinary pathogens to the most commonly used antimicrobial medications, especially in patients with diabetes and pregnant women. Although UTIs rarely cause complications, they can have serious consequences in terms of morbidity and mortality.

Sociodemographic factors such as maternal age, residence, marital status, maternal educational status, monthly family income, and maternal occupation, as well as medical and obstetric-related factors such as anaemia, HIV status, history of UTI, history of catheterization, parity, and gestational age, have been identified as potential-associated factors for UTI in pregnant women.

The objective of this study by Abayeneh Girma et al was to provide evidence on the general prevalence and risk factors for UTIs among patients with DM and PW using previously conducted research articles. Furthermore, the results obtained in the current investigation could significantly benefit healthcare providers, users, and policymakers.

Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, Google Engine, and University Library Databases. “Prevalence,” “urinary tract infection,” “associated factors,” “pregnant women,” “diabetic patients,” and “Ethiopia” were search terms used for this study.

For this meta-analysis, a total of 7271 participants were included in the 25 eligible studies. The pooled prevalence of UTI in Ethiopia among both patients was 14.50%, of which 14.21% and 14.75% were cases of DM and PW, respectively. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (19.84%) and in studies conducted from 2018 to 2022 (14.68%). Being female (P = 0:01) and having an income level ≤ 500ETB (P = 0:03) were risk factors significantly associated with UTI among patients with DM and PW, respectively. Furthermore, a history of catheterization (P < 0:01), urinary tract infection (P < 0:01), and symptomatic patients (P < 0:01) were significantly associated with UTI in both patients.

Urinary tract infections and other noncommunicable diseases are becoming more prevalent in developing countries like Ethiopia due to a lack of problem identification, effective treatment, and intervention measures. The overall pooled prevalence of UTI among both DM and PW patients was 14.50%. Being female and having a family income level ≤ 500 ETB had a higher risk of acquiring UTI among DM and PW patients, respectively. Furthermore, patients with a previous history of UTI, catheterization, or symptomatic patients had higher odds of contracting UTI than those who had no previous history of UTI, catheterization, or asymptomatic patients. Increasing the community’s knowledge about frequent urine analysis and antenatal care services, blood sugar tests, early diagnosis, and proper medications should be addressed to alleviate the prevalence of UTI in patients with DM and PW.

Source: Abayeneh Girma, Aleka Aemiro, Dereba Workineh; Hindawi Journal of Pregnancy Volume 2023

https://doi.org/10.1155/2023/8365867