How Risky Are UTIs During Pregnancy?

My dear mom-to-be, did your doctor just mention you have a urinary tract infection (UTI)? Don’t worry—you are not alone. Yes, UTIs are surprisingly common during pregnancy and they can be risky for both mother and child if left untreated. The good news is that with the right care, they are completely manageable. Understanding what a UTI is and knowing how to handle it effectively can make all the difference. In this blog, we aim to provide you with a comprehensive understanding of UTI during pregnancy and how to ensure both you and your little one stay healthy throughout this special time.

What Are UTIs During Pregnancy?

UTIs during pregnancy are a common bacterial infection and are often considered a prenatal complication that can occur in any part of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections often develop between weeks six and 24 of pregnancy, as the growing uterus exerts pressure on the bladder. This pressure can hinder urine flow, creating an ideal environment for bacterial growth¹.

What Are The Causes Of UTIs During Pregnancy?

During pregnancy, the body undergoes hormonal and physiological changes to support the developing fetus and these changes can affect the urinary tract, increasing the risk of infections in expectant mothers. As the uterus expands, it puts pressure on the bladder, reducing its capacity to hold urine and resulting in residual urine ².

Elevated progesterone levels during pregnancy relax the smooth muscle tissue in the urinary system, causing dilation of ureters and renal calyces (the cup-shaped structures in the kidneys that collect urine). This slows down the urine flow, leading to a condition called urinary stasis (urine remains in the urinary tract for longer periods). Thus, creating an ideal environment for bacteria to access the urinary tract, leading to infections ².

The presence of Escherichia coli (E. coli) bacteria in the urinary tract during pregnancy can result in urinary infections. As the pregnancy progresses, these infections can lead to complications. One potential issue is intrauterine growth restriction, where the fetus is smaller than expected. Additionally, the baby may face potential congenital anomalies, where the baby’s organs or body parts do not develop as expected³.

2 Types Of UTIs During Pregnancy

In pregnant women, based on the site of infections, UTIs are classified into two types: lower urinary tract infections and upper urinary tract infections. ².

1) Lower Urinary Tract Infections

a) Asymptomatic bacteriuria: 

Bacteria can often be present without showing symptoms, but if left untreated, they may lead to an increased risk of preterm birth and low birth weight.⁴

b) Cystitis: 

It is a condition characterised by inflammation of the bladder. If left untreated, there is a high risk of the infection spreading to the kidneys.⁵

2) Upper Urinary Tract Infection

a) Pyelonephritis: 

A lower urinary tract infection can become life-threatening if left untreated. It may spread to the kidneys, potentially resulting in permanent kidney failure. ⁶

9 Symptoms To Watch For UTI During Pregnancy

Recognising symptoms on time plays a very crucial role in managing UTIs during pregnancy. Here is a list of key symptoms ¹ to watch out for:

• Pain or burning sensation while urinating
• Urinary incontinence
• Blood in urine
• Frequently urinating
• Fever
• Chills
• Mental changes or confusion
• Vomiting
• Flank pain (discomfort or pain typically between the lower ribs and the hip).

3 Risk Factors Of UTI During Pregnancy 

Pregnant women are vulnerable to urinary tract infections (UTIs). Understanding the risk factors is essential for protecting the health and safety of both mother and baby.

1) Age:

Age is a significant factor in the risk of developing UTIs, particularly among women aged 26-35. Research suggests that as women grow older, they become increasingly susceptible to bacterial infections, which heightens their risk of urinary tract infections. This vulnerability is attributed to physiological changes and immune system variations associated with aging. By recognising these factors, pregnant women can take proactive steps to manage their health effectively.⁷

2) Obstetric factors:

First-time mothers are more susceptible to urinary tract infections (UTIs) than those who have had multiple pregnancies.⁷

3) Gestational age:

Pregnant women face an increased risk of urinary tract infections (UTIs) in their third trimester due to various anatomical and physiological changes occurring in their bodies.

6 Tips To Prevent UTIs During Pregnancy

To maintain a healthy urinary system and reduce the risk of UTIs, consider these essential tips:

• Drink lots of fluids to flush out bacteria from your urinary tract.
• Pass urine frequently. Holding urine for a longer period may lead to infections.
• Choose all-cotton undergarments to keep the area breathable and dry.
• Practice good hygiene around genital areas, especially before and after sexual activity.
• Use mild, unscented soaps and avoid soaps that may irritate the urethra.
• Stay alert for any UTI symptoms, such as pain or burning during urination.

Diagnosis of UTIs During Pregnancy:

To diagnose a UTI during pregnancy, healthcare providers typically use two urine tests¹:

1) Urinalysis: 

A urine sample will be collected to check for signs of infection, such as bacteria, white blood cells, and blood. The presence of these substances in the urine often indicates a UTI.

2) Urine Culture: 

If the initial urinalysis suggests a UTI, a urine culture may be done to identify the specific bacteria causing the infection. This helps in choosing the right antibiotic for treatment.

If you notice any symptoms, consult your doctor right away. Early diagnosis is crucial for timely intervention and can prevent the condition from progressing.

Treatment for UTIs During Pregnancy 

Doctors prescribe antibiotics to treat urinary tract infections (UTIs) during pregnancy. These medications play a crucial role in managing uterine conditions. Penicillin, amoxicillin, and erythromycin are the commonly prescribed antibiotics for pregnant women.⁸

When Should I Seek Care for a UTI During Pregnancy?

If you observe any symptoms, be sure to reach out to your doctor immediately. Delaying treatment can allow the infection to progress, potentially leading to complications that could affect both you and your baby. 

Final thoughts:

Urinary tract infections (UTIs) during pregnancy are common and manageable, but they can lead to pregnancy complications. Understanding the causes, risks, and symptoms of UTIs during pregnancy gives you a unique advantage for a healthier pregnancy. Proactively getting a urinalysis and urine culture test is one such way forward that can help with timely treatment.

Frequently Asked Questions (FAQ):

1) How do you treat a UTI while pregnant?

Treatment for UTIs during pregnancy typically involves antibiotics that are safe for both the mother and the baby. Your doctor will prescribe the medication based on the type of bacteria causing the infection. Additionally, staying hydrated and following good genital hygiene practices can help prevent infections.

2) What is the fastest way a UTI can go away?

The fastest way to treat UTIs during pregnancy is to start antibiotics prescribed by a healthcare provider as soon as the infection is diagnosed. Depending on the severity, symptoms can improve within a few days of starting treatment. However, it’s crucial to finish the entire prescribed course to ensure the infection is fully cleared and prevent resistance.

3) Can an ultrasound detect a UTI?

An ultrasound is not used to diagnose a UTI. But it is primarily used to examine the kidneys, bladder, and urinary tract for any structural complications. Urinalysis and urine culture are the two primary tests to detect the presence of bacteria and other signs of infection.

4) Can a UTI affect getting pregnant?

A UTI itself directly does not affect a woman’s ability to get pregnant. However, a history of recurrent or untreated UTIs can lead to serious complications. For example, an untreated UTI may cause kidney infections or pelvic inflammatory disease (PID), both of which can damage reproductive organs.