Background and Aims: Urinary tract
infections (UTIs) are common among pregnant women and major predisposing
factors for pyelonephritis linked to obstetrical complications including
preterm labour and low infants’ birth weights. This study sought to determine
the relationship(s) between pregnancy trimesters, UTIs and changes in
progesterone levels among pregnant women. Materials and Methods: The
study was conducted in 2016 at Moi Teaching and Referral Hospital (MTRH)
antenatal clinic which is a referral facility that attends to patients from
most Counties in western region of Kenya. A cross-sectional study design was
used to collect blood and urine specimens from 78 participants. Blood was used
to determine progesterone levels using ELISA technique and urine cultures with
bacterial colony counts ≥105 were
appropriately identified to species level. Trimester periods and participants’
demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in
urine from the pregnant women was Escherechia
coli (63.7%). The more affected age-group was women between 30-39 years during trimester three, suggesting that bacterial colonization
of genital track occurred more frequently in older compared to the younger
women. There was an exponential increase in progesterone levels among the
pregnant women during trimester three compared to other trimesters, although
these increases occurred independent of age. However, high levels of progesterone among
pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The
results showed that progesterone levels increase with trimester and the most
prevalent bacteria associated with this was E.
coli even though age and increase in progesterone
References
[1]
Izadi, B., Rostami-Far, Z., Jalilian, N., Khazaei, S., Amiri, A., Hamid, M.S. and Rostami-Far, M. (2016) Urinary Tract Infection (UTI) as a Risk Factor of Severe Preeclampsia. Global Journal of Health Science, 8, 77-82. https://doi.org/10.5539/gjhs.v8n11p77
[2]
Arinzon, Z., Shabat, S., Peisakh, A. and Berner, Y. (2012) Clinical Presentation of Urinary Tract Infection (UTI) Differs with Aging in Women. Archives of Gerontology and Geriatrics, 55, 145-147. https://doi.org/10.1016/j.archger.2011.07.012
[3]
Masinde, A., Gumodoka, B., Kilonzo, A. and Mshana, S.E. (2009) Prevalence of Urinary Tract Infection among Pregnant Women at Bugando Medical Centre, Mwanza, Tanzania. Tanzania Journal of Health Research, 11, 154-159. https://doi.org/10.4314/thrb.v11i3.47704
[4]
Nanda, N. and Juthani-Mehta, M. (2009) Novel Biomarkers for the Diagnosis of Urinary Tract Infection—A Systematic Review. Biomarker Insights, 4, 111-121. https://doi.org/10.4137/BMI.S3155
[5]
Duarte, G., Marcolin, A.C., Quintana, S.M. and Cavalli, R.C. (2008) Urinary Tract Infection in Pregnancy. Revista Brasileira de Ginecologia e Obstetrícia, 30, 93-100. https://doi.org/10.1590/S0100-72032008000200008
[6]
Lishko, P.V., Botchkina, I.L. and Kirichok, Y. (2011) Progesterone Activates the Principal Ca2+ Channel of Human Sperm. Nature, 471, 387-391. https://doi.org/10.1038/nature09767
[7]
Zen, M., Ghirardello, A., Iaccarino, L., Tonon, M., Campana, C., Arienti, S., Rampudda, M., Canova, M. and Doria, A. (2010) Hormones, Immune Response, and Pregnancy in Healthy Women and SLE Patients. Swiss Medical Weekly, 140, 187-201. https://doi.org/10.4414/smw.2010.12597
[8]
Agresti, A. (2002) Categorical Data Analysis. Second Edition, John Wiley & Sons, Inc, Hoboken, 710. https://doi.org/10.1002/0471249688
[9]
Agresti, A. (2007) An Introduction to Categorical Data Analysis. Wiley, Hoboken, 325-331. https://doi.org/10.1002/0470114754
[10]
Onoh, R.C., Umeora, O.U.J., Egwuatu, V.E., Ezeonu, P.O. and Onoh, T.J.P. (2013) Antibiotic Sensitivity Pattern of Uropathogens from Pregnant Women with Urinary Tract Infection in Abakaliki, Nigeria. Infection and Drug Resistance, 6, 225-233. https://doi.org/10.2147/IDR.S46002
[11]
Gebrehiwot, A., Lakew, W., Moges, F., Moges, B., Anagaw, B., Yismaw, G., Nega, T., Unakal, C. and Kassu, A. (2012) Bacterial Profile and Drug Susceptibility Pattern of Neonatal Sepsis in Gondar University Hospital, Gondar Northwest Ethiopia. Der Pharmacia Lettre, 4, 1811-1816.
[12]
Farahmand, B., Rasaee, M., Maleknia, N. and Malekaneh, M. (1998) Enzyme-Linked Immunosorbent Assay of Progesterone in Serum Using Penicillinase as Label. Iranian Biomedical Journal, 2, 115-122.
[13]
Johansson, E.D.B. (1969) Progesterone Levels in Peripheral Plasma during the Luteal Phase of the Normal Human Menstrual Cycle Measured by a Rapid Competitive Protein Binding Technique. European Journal of Endocrinology, 61, 592-606. https://doi.org/10.1530/acta.0.0610592
[14]
(2014) Kenya Demographic Health Survey (KDHS). https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
[15]
Campbell, D. (2010) The Best Age to Become a Mother—Between 20 and 35. https://www.theguardian.com/society/2010/dec/31/pregnancy-mothers-fertility-children
[16]
Emiru, T., Beyene, G., Tsegaye, W. and Melaku, S. (2013) Associated Risk Factors of Urinary Tract Infection among Pregnant Women at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia. BMC Research Notes, 6, Article No. 292. https://doi.org/10.1186/1756-0500-6-292
[17]
Hamdan, H.Z., Ziad, A.H.M., Ali, S.K. and Adam, I. (2011) Epidemiology of Urinary Tract Infections and Antibiotics Sensitivity among Pregnant Women at Khartoum North Hospital. Annals of Clinical Microbiology and Antimicrobials, 10, Article No. 2. https://doi.org/10.1186/1476-0711-10-2
[18]
Bien, J., Sokolova, O. and Bozko, P. (2012) Role of Uropathogenic Escherichia coli Virulence Factors in Development of Urinary Tract Infection and Kidney Damage. International Journal of Nephrology, 2012, Article ID: 681473. https://doi.org/10.1155/2012/681473
[19]
Ronald, A. (2003) The Etiology of Urinary Tract Infection: Traditional and Emerging Pathogens. Disease-a-Month, 49, 71-82. https://doi.org/10.1067/mda.2003.8
[20]
Sfakianaki, A.K. and Norwitz, E.R. (2006) Mechanisms of Progesterone Action in Inhibiting Prematurity. The Journal of Maternal-Fetal and Neonatal Medicine, 19, 763-772. https://doi.org/10.1080/14767050600949829
[21]
Tadesse, E., Teshome, M., Merid, Y., Kibret, B. and Shimelis, T. (2014) Asymptomatic Urinary Tract Infection among Pregnant Women Attending the Antenatal Clinic of Hawassa Referral Hospital, Southern Ethiopia. BMC Research Notes, 7, Article No. 155. https://doi.org/10.1186/1756-0500-7-155
[22]
WHO (2010) WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy.