Maternal urinary tract infection during pregnancy and long-term infectious morbidity of the offspring

Early Hum Dev. 2019 Sep;136:54-59. doi: 10.1016/j.earlhumdev.2019.07.002. Epub 2019 Jul 15.

Abstract

Background: Urinary tract infection (UTI) is a common bacterial infection in pregnant women and is associated with adverse perinatal outcomes. We sought to investigate the long-term infectious outcomes of children to mothers who were diagnosed with UTI during their pregnancy.

Methods: A population-based cohort analysis was conducted at a single tertiary medical center. The study included all singleton deliveries between the years 1991-2014, comparing offspring born to mothers diagnosed with UTI during their pregnancy with those born to non-exposed mothers. Infectious-related hospitalizations of the offspring up to the age of 18 years were assessed according to a predefined set of ICD-9 codes. A Kaplan-Meier survival curve was conducted to compare cumulative hospitalization incidence between the groups. A Cox regression model was used to adjust for confounders.

Results: During the study period, 243,725 deliveries met the inclusion criteria. Of them, 8034 (3.3%) were exposed to maternal UTI during pregnancy. Infectious-related hospitalizations were significantly prevalent in offspring to exposed mothers (12.3% vs. 11.0%, OR = 1.125, 95% CI 1.051-1.204, Kaplan-Meier log rank p < 0.001). In the Cox regression model, while controlling for clinically relevant confounders, maternal UTI (adjuster HR = 1.240), as well as preterm delivery (adjusted HR = 1.385) and cesarean delivery (adjusted HR = 1.198) were noted as independent risk factors for long-term infectious morbidity of the offspring.

Conclusions: Maternal UTI in pregnancy may influence offspring susceptibility to pediatric infections, as it was found to be an independent risk factor for long-term infectious morbidity of the offspring.

Keywords: Fetal; Infectious morbidity; Long-term morbidity; Pregnancy; UTI.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Urinary Tract Infections / epidemiology*