Urinary tract infections (UTIs) are a common concern for many pregnant individuals, often leading to questions about their potential impact on pregnancy outcomes. This article aims to clarify the relationship between UTIs and miscarriage, providing evidence-based information to help pregnant individuals understand this topic.
Understanding UTIs During Pregnancy
A urinary tract infection (UTI) occurs when bacteria infect any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. Pregnant individuals are more susceptible to UTIs due to a combination of hormonal and physical changes. Hormones, such as progesterone, can relax the smooth muscles of the urinary tract, leading to slower urine flow and dilation of the ureters, which are the tubes connecting the kidneys to the bladder. The growing uterus also places pressure on the bladder, making it harder to empty completely, and residual urine can create an environment conducive to bacterial growth.
UTIs in pregnancy can manifest in different ways. Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine without any noticeable symptoms, and it affects about 2% to 10% of pregnant women. If untreated, ASB can progress to symptomatic infections. Cystitis is a bladder infection, while pyelonephritis is a more severe infection that has spread to the kidneys.
The Link Between UTIs and Pregnancy Complications
While UTIs are common during pregnancy, a simple, treated UTI typically does not lead to miscarriage. However, untreated or severe UTIs can be associated with an increased risk of certain pregnancy complications. If a UTI, particularly asymptomatic bacteriuria, is left untreated, it can ascend and develop into pyelonephritis, a kidney infection. Pyelonephritis is a serious condition that can cause systemic inflammation and may lead to adverse pregnancy outcomes.
Untreated pyelonephritis in pregnancy is associated with a higher risk of complications such as preterm labor and low birth weight. In severe cases, it can lead to maternal sepsis, a life-threatening infection, potentially contributing to miscarriage or stillbirth. The inflammation can also trigger uterine contractions, increasing the risk of premature delivery. Prompt diagnosis and treatment reduce these risks and support a healthy pregnancy.
Recognizing and Addressing UTIs in Pregnancy
Recognizing UTI symptoms during pregnancy allows for timely intervention. Common symptoms include a frequent or urgent need to urinate, a burning sensation during urination, and lower abdominal or pelvic pain. Urine may also appear cloudy or have a strong odor. More severe symptoms, such as fever, chills, nausea, vomiting, or pain in the upper back or side, can indicate a kidney infection (pyelonephritis).
Diagnosis of a UTI in pregnancy typically involves a urine test. A urinalysis checks for white blood cells, red blood cells, and bacteria in the urine, indicating an infection. A urine culture is then performed to identify the specific type of bacteria causing the infection and determine which antibiotics will be most effective. Prompt treatment with pregnancy-safe antibiotics is recommended, with common choices including amoxicillin, cephalexin, and nitrofurantoin. Complete the full course of antibiotics as prescribed, even if symptoms improve, to fully clear the infection.
Preventive Measures and When to Seek Care
Taking proactive steps can help reduce the likelihood of developing UTIs during pregnancy. Staying well-hydrated by drinking plenty of water helps to flush bacteria from the urinary tract. Urinating frequently and emptying the bladder completely, as well as urinating before and after sexual intercourse, can also help prevent bacterial buildup. Proper hygiene, such as wiping from front to back after using the toilet, helps prevent bacteria from the bowel from entering the urethra. Wearing cotton underwear and avoiding tight clothing can also promote airflow and reduce moisture.
Regular prenatal check-ups often include routine urine screenings for asymptomatic bacteriuria. This screening, typically done with a urine culture in early pregnancy, allows for the detection and treatment of bacteria before symptoms develop, preventing potential complications. If any UTI symptoms are experienced, or if there is concern about a possible infection, seek medical attention promptly. Early detection and treatment manage UTIs and support a healthy pregnancy.