Urinary tract infection in pregnancy was associated with mental retardation or developmental delay in infants

Abstract:

OBJECTIVE To determine if there is an association between urinary tract infection (UTI) during pregnancy and mental retardation or developmental delay in the infants. DESIGN Retrospective cohort study. SETTING Population-based study in the USA. SUBJECTS 40,815 infants, born in South Carolina in 1995-1996, and their mothers. 87% of Medicaid (state-funded) births in the state were included. Cases of stillbirth or neonatal death were excluded. METHODS Computerized Medicaid records of mothers and infants were linked through birth certificate records. Mothers were categorized into three groups: those who had UTI during pregnancy and filled a prescription for antibiotics, those who had UTI but did not fill a prescription, and those who had no UTI during pregnancy. UTI was assumed if specifically stated as a diagnosis, or if urinalysis or urine culture was performed, followed within 14 days by a claim for antibiotics. Infant records were searched up to 1998 for diagnoses of mental retardation or developmental delay of unknown cause. MAIN OUTCOME MEASURES Relative risk (RR, 95% CI) for mental retardation or developmental delay in infants of women with untreated UTI, compared to women with treated UTI and those without UTI, adjusted for other risk factors, such as maternal age, gestational age at first prenatal visit and birth, race, and alcohol use. MAIN RESULTS 8,578/40,815 (21%) mothers had UTI during pregnancy, 2013 (24%) of whom did not fill a prescription for antibiotics. The prevalence of mental retardation or developmental delay was 185/2013 (9.2%) in the untreated UTI group, 448/6565 (7.4%) in the treated UTI group, and 2205/32,237 (6.8%) in the no UTI group (all pairwise comparisons significantly different). The prevalences of mental retardation alone were 1.9%, 1.6%, and 1.4%, respectively. The adjusted RR for mental retardation or developmental delay in the untreated UTI group was 1.31 (1.11-1.54) compared to the no UTI group and 1.22 (1.02-1.47) compared to the treated UTI group. It appeared that the infant was at greater risk if the UTI occurred during the first or third trimesters, compared to the second trimester. The increased risk with untreated UTI persisted even when it was assumed that some women in the ’untreated’ group may had received antibiotics from another source and some women in the ’treated’ group may not have taken their prescription. CONCLUSION Mental retardation or developmental delay in infants was significantly associated with untreated urinary tract infection during pregnancy. © 2001 Harcourt Publishers Ltd.

Año de publicación:

2001

Keywords:

Fuente:

scopus