Risk factors associated with acute pyelonephritis in pregnant women, from third-party payer institutions in Colombia, between 2008 and 2012. A case-control study
DOI:
https://doi.org/10.18597/rcog.35Keywords:
Pyelonephritis, risk factors, pregnancy, case-control studies, ColombiaAbstract
Objective: To identif y risk factors for the development of acute pyelonephritis in pregnant women in Barranquilla, Bogotá, Bucaramanga, Cali and Medellín (Colombia) covered by a health benefits management organization.
Materials and methods: Case-control study with two controls for every case. Selection criteria: pregnant women presenting for delivery between January 1st, 2008 and December 31st, 2012 to the different healthcare institutions of a thrird-party payer. Women with urinary tract abnormalities were excluded. Cases were defined as those diagnosed with acute pyelonephritis during pregnancy. Controls were defined as pregnant women delivered during the same period, not diagnosed with pyelonephritis. Cases were selected consecutively on the basis of convenience, and controls were selected at random. Gestational, social and demographic variables, and comorbidities were measured. Association was assessed using bivariate and multivariate analysis.
Results: An incidence of 3.5 cases of acute pyelonephritis for every 10,000 pregnant women was found. The diagnosis was made between weeks 5 and 38 of gestation, the vast majority during the second (40.2%) and the third (48.0%) trimesters. None of the cases had a history of pyelonephritis. An association was found between acute pyelonephritis, first pregnancy (OR = 1.94; IC 95%: 1.13-3.33), being a teenager (OR = 2.85; IC 95%: 1.51-5.40), and urinary tract infection before pregnancy (OR 2.29; IC 95%: 1.17-4.44).
Conclusion: Risk factors for acute gestational pyelonephritis include first pregnancy, being a teenager and having a history of urinary tract infection before pregnancy.
Author Biographies
Jessika Lissethe López-Martínez
Yanett Marcela Montoya-Jaramillo
Dedsy Yajaira Berbesi-Fernández
References
Fiadjoe P, Kannan K, Rane A. Maternal urological problems in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2010;152:13-7.
Foxman B, Klemstine K, Brown P. Acute pyelonephritis in US hospitals in 1997: hospitalization and in-hospital mortality. Ann Epidemiol. 2003;13:144-50.
Calderón U, Doren A, Cruz M, Cerda J, Abarzúa C. Pielonefritis aguda en el embarazo y susceptibilidad antimicrobiana de uropatógenos. Comparación de dos décadas. Rev Chil Obstet Ginecol. 2009;74:88-93.
Farkash E, Weintraub A, Sergienko R, Wiznitzer A, Zlotnik A, Sheiner E. Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and outcomes. Eur J Obstet Gynecol Reprod Biol. 2012; 162:24-7.
Wing DA, Fassett MJ, Getahun D. Acute pyelonephritis in pregnancy: an 18-year retrospective analysis. Am J Obstet Gynecol. 2014;210:219.e1-6. doi: 10.1016/ j.ajog.2013.10.006
Gilstrap L, Cunningham F, Whalley P. Acute pyelonephritis in pregnancy: an anterospective study. Obstet Gynecol. 1981;57:409-13.
Fahey T, Webb E, Montgomery A, Heyderman R. Clinical management of urinary tract infection in women: a prospective cohort study. Fam Pract. 2003;20:1-6.
Pazos N, Fuentes L, Ferrández B, Martínez C, Martínez M, Osuna J. Pyelonephritis and pregnancy. Our experience in a general hospital. An Med Interna Madr Spain. 1984 2007;24:585-7.
Czaja C, Scholes D, Hooton T, Stamm W. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis Off Publ Infect Dis Soc Am. 2007; 45:273-80.
Pemberthy C, Gutiérrez J, Arango N, Monsalve M, Giraldo N, Gutiérrez F, et al. Aspectos clínicos y farmacoterapéuticos de la infección del tracto urinario. Revisión estructurada. Revista CES Medicina. 2011;25:135-51.
Sánchez J, Lomanto A. Factores de riesgo y complicaciones de la infección de vías urinarias durante el embarazo. Rev Colomb Obstet Ginecol. 1991;42: 261-8.
Szklo M, Nieto F. Epidemiología intermedia: conceptos y aplicaciones. Madrid: Díaz de Santos; 2003.
Sui A, Chung-Joo B. Pielonefritis aguda y gestación. Ginecol Obstet. 2001;47:171-6.
Sharma P, Thapa L. Acute pyelonephritis in pregnancy: a retrospective study. Aust N Z J Obstet Gynaecol. 2007;47:313-5.
Hill J, Sheffield J, McIntire D, Wendel G. Acute pyelonephritis in pregnancy. Obstet Gynecol. 2005; 105:18-23.
Leppälahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open. 2013;3:e003225. doi:10.1136/bmjopen-2013-003225
Sharma P, Thapa L. Acute pyelonephritis in pregnancy: a retrospective study. Aust N Z J Obstet Gynaecol. 2007;47:313-5.
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