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Background: Current management recommendations for asymptomatic bacteriuria (ABU) in pregnancy is based primarily on expert opinion and requires further study. We examined the role of screening urine cultures and “test of cure” urine cultures (TOC) on pregnancy outcomes in women with ABU.Methods: This retrospective case-control study examined pregnancy outcomes of patients who received prenatal care and delivered in 2018-2019 in a tertiary-care academic center. Women with ABU (n=174) were defined as having a positive screening urine culture during their pregnancy (>100,000 CFU/mL of one organism or >10,000 CFU/mL for Group B Streptococcus). These cases were compared with matched controls with negative screening urine cultures (n=348) in a 1:2 ratio. We further investigated the difference in pregnancy outcomes noted in groups of patients with a positive TOC versus those who cleared ABU, with a documented negative TOC. Analysis was performed with Chi-square, one-way ANOVA, and Independent Sample T-Tests for categorical variables, between-group variability, and continuous variables, respectively. Odds ratios are reported for case-control comparison of dichotomous outcomes.Results: Pregnant patients with ABU had significantly higher rates of symptomatic cystitis than controls, and pyelonephritis only occurred in patients diagnosed with ABU. 118 patients (67.8%) with ABU had TOC performed after treatment with antibiotics and 28 (23.7%) had persistently (+)TOCs. This group had significantly higher rates of antepartum admission, delivery at Conclusions: During pregnancy, ABU is associated with higher rates of maternal complications. Despite treatment, positive TOCs were common, and associated with higher complication rates. This supports continued use of screening UCs at prenatal visits and TOCs to evaluate treatment response and identify patients at increased risk for complications |
