Asymptomatic bacteriuria: predisposing factors and correlation with preterm labor in low resource settings

Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB) to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in low resource settings.Methods: A total of 1000 pregnant mothers in second and third trimester of pregnancy were screened for ASB by using two rapid reagent strip tests, namely nitrate and leukocyte esterase reagent strip tests. Out of those screened positive hundred consecutive pregnant women were taken as cases, after positive urine culture and out of those screened negative, two hundred patients were followed as controls after matching and pairing with cases. A detailed history was taken from each patient to determine all risk factors for ASB. The cases and controls were followed prospectively till delivery.Results: Mean gestational age at the time of labor in 100 cases of ASB was 35.6 ± 2.9 weeks and in 200 controls was 37.9 ± 0.6 weeks. The difference between mean gestational age at the time of labor in cases and controls was statistically significant (P value 0.000). The likelihood of preterm labor in the cases was 14.5 times more than the control and the difference was significant   (P <0.05).Conclusions: ASB leads to a higher rate of preterm labor and is more frequently seen in population with anemia, illiteracy, rural background and low socioeconomic status.

Interpregnancy interval raise odds of adverse perinatal outcome in high fertility region Mewat, Haryana

Background: Objective of current study was to study association between various interpregnancy intervals and adverse perinatal outcome (preterm birth, low birth weight, small for gestational age) and to come out with optimum interpregnancy interval.Methods: Retrospective cross sectional study in which 400 meo women (para 2 to para 5) fulfilling inclusion and exclusion criteria having diverse interpregnancy intervals were selected. Statistical analysis was done using SPSS. We used multivariate logistic regression analysis to assess the risk of adverse perinatal outcome.Results: As compared with infants conceived within a time period of16 to 48 months after a live birth, infants conceived within16 months after a live birth had odds ratios of 2.1 (95% CI 1.3 to 3.5) for low birth weight, 2.2 (95% CI 1.3 to 3.8) for preterm birth,and 2.3 (95% CI 1.4 to 3.8) for smallsize for gestational age; infants conceived more than 48 months after a live birth had odds ratios of 1.88 (95% CI 1.1 to 3.1), 1.96 (95% CI1.1 to 3.4), and 2.08 (95% CI 1.2 to3.6) for these three adverse outcomes, respectively; P value <0.05.Conclusions: We came to conclusion that interpregnancy interval of 16 - 48 months is the optimal interval carrying least risk of adverse perinatal outcomes and both short as well as long interpregnancy intervals are significantly associated with birth of preterm, low birth weight and small for gestational age babies. Counselling regarding optimal interpregnancy interval and methods of contraception can go a long way in reducing adverse perinatal outcome