From the Research
The frequency of urinary tract infections causing preterm labor that subsequently leads to early onset sepsis in preterm babies is relatively low, with approximately 1-2% of preterm infants developing early onset sepsis. This connection occurs because maternal UTIs, particularly pyelonephritis, can trigger inflammatory responses that initiate uterine contractions and cervical changes. The most common pathogens involved are E. coli, Klebsiella, and group B streptococcus, which can ascend from the urinary tract to the amniotic fluid or be transmitted during delivery 1. Prevention focuses on routine urine screening during pregnancy, prompt antibiotic treatment of bacteriuria (typically with safe options like nitrofurantoin, cephalexin, or amoxicillin for 3-7 days), and close monitoring of women with UTIs for signs of preterm labor. For women with recurrent UTIs during pregnancy, antibiotic prophylaxis may be considered to prevent complications including preterm birth and subsequent neonatal sepsis. According to a study published in 2020, maternal history of urinary tract infection during the third trimester of pregnancy is associated with an increased risk of neonatal sepsis, with an adjusted odds ratio of 2.75 (95% CI: 1.04-7.23, p <0.05) 1. Another study published in 2013 highlights the importance of screening and treatment of UTI in pregnancy to improve birth outcomes and reduce maternal and neonatal morbidity and mortality 2. However, the most recent study in 2023 found that early antibiotic exposure in low-risk late preterm and term infants did not reduce the risk of early onset sepsis, and antibiotic stewardship efforts may be beneficial in this population 3. Overall, while the frequency of UTIs causing preterm labor and subsequent early onset sepsis is relatively low, it is still a significant concern and prevention efforts should focus on routine urine screening, prompt antibiotic treatment, and close monitoring of women with UTIs. Key points to consider include:
- Routine urine screening during pregnancy to detect UTIs
- Prompt antibiotic treatment of bacteriuria to prevent preterm labor and subsequent neonatal sepsis
- Close monitoring of women with UTIs for signs of preterm labor
- Antibiotic prophylaxis for women with recurrent UTIs during pregnancy to prevent complications
- The importance of antibiotic stewardship efforts to reduce unnecessary antibiotic exposure in low-risk populations.