Urinary tract infections during pregnancy in South Carolina.

This study presents evidence that over 20 percent of pregnant women with a UTI in South Carolina did not have an antibiotic pharmacy claim within 14 days of diagnosis. Untreated maternal UTI in pregnancy was associated with a 22 percent increased risk for MR/DD in the infant compared to the risk for women who had a UTI and a pharmacy claim for an antibiotic and 31 percent increased risk compared to women who did not have a UTI. The importance of medications compliance should be emphasized in the care of pregnant women.

Perinatal risk for mortality and mental retardation associated with maternal urinary-tract infections.

OBJECTIVE: The researchers analyzed the relationship between fetal exposure to maternal urinary tract infections (UTIs) and mental retardation or developmental delay and fetal death. STUDY DESIGN: A retrospective cohort design was used to explore the risk for fetal death and mental retardation or developmental delay associated with exposure to maternal UTI during pregnancy. POPULATION: Matched maternal-child pairs from the National Collaborative Perinatal Project (NCPP) from the decades of 1960 and 1970 were compared with a previous analysis of the South Carolina Medicaid Reimbursement System (Medicaid) for 1995-1996. Both data sets are representative of poor women and their children. OUTCOMES MEASURED: The outcomes measured were fetal death and mental retardation or developmental delay in the live-born children. RESULTS: There was an increased relative risk (RR) for mental retardation or developmental delay in the third trimester of pregnancy (RR=1.40; 95% confidence interval [CI], 1.01-1.95) in the NCPP, and there was a similar risk in the Medicaid data. The third trimester relative hazard for fetal death associated with maternal UTI was 2.23 (95% CI, 1.40-3.55). CONCLUSIONS: The findings support an association between maternal UTI and fetal death and mental retardation or developmental delay. These results confirm the importance of diligent diagnosis and treatment of maternal UTI by prenatal care providers.

Urinary tract infections during pregnancy and mental retardation and developmental delay.

OBJECTIVE: To investigate the association between urinary tract infections during pregnancy and mental retardation or developmental delay in infants. METHODS: An inception cohort design was used to analyze Medicaid maternal and infant-linked records and vital records for 41,090 pregnancies from 1995-1998. RESULTS: The relative risk (RR) for mental retardation or developmental delay among infants of mothers with diagnosed urinary tract infections but no antibiotic claims was 1.31 with a 95% confidence interval (CI) of 1. 12, 1.54 compared with the group without urinary tract infections. The RR for infants of mothers with urinary tract infections without antibiotic claims was 1.22 (95% CI 1.02, 1.46) compared with infants of mothers with urinary tract infections and antibiotic claims. The RR was significant in the first trimester (1.46, 95% CI 1.07, 1.99) and third trimester (1.41, 95% CI 1.11, 1.79) after controlling for race and gestational age at birth. CONCLUSION: There was a statistically significant association between maternal urinary tract infections without evidence of antibiotics and mental retardation or developmental delay in infants. The relationship persisted when we assumed that over 30% of women who had antibiotic claims filled but did not take the medicine, and 40% of the women who did not have antibiotic claims did take the medication.