Prevalence Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):425-431
DOI 10.1590/S0100-72032012000900007
PURPOSE: To evaluate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among women candidates to in vitro fertilization (IVF) in a reference public service in southeastern Brazil. METHODS: Women who were referred for IVF from April 1st, 2008 to December 31st, 2009 were enrolled sequentially in the study. A ginecological-obstetrical background questionnaire was applied and endocervical swab samples were obtained to search for CT and NG using hybrid capture and PCR. The variables studied were: age, color, education, duration of infertility, number of pregnancies and living children, history of miscarriage, ectopic pregnancy, number of sex partners, pelvic inflammatory disease (PID), pelvic surgery, manipulation of the uterine cavity, smoking, and illicit drug use. The women were distributed according to the presence/absence of confirmed chlamydia infection and descriptive analysis was employed. RESULTS: Among 176 women tested the prevalence of CT infection was 1.1% and there was no NG infection. Two thirds of the women were >30 years old, with schooling >8 years and <5 years of infertility, and 56.2% had no children. The main background data were pelvic surgery (77.8%), manipulation of the uterine cavity (62.5%) and PID (27.8%). The tubal factor was the most prevalent, 73.3% of women (from 129), 37.5% had been sterilized, 35.8% had not been sterilized, and other factors had a prevalence <30%. CONCLUSIONS: CT and NG infections had a low prevalence in this sample. Studies at other centers in the country are needed to confirm the prevalence of infection in this particular group of infertile women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):425-431
DOI 10.1590/S0100-72032012000900007
PURPOSE: To evaluate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among women candidates to in vitro fertilization (IVF) in a reference public service in southeastern Brazil. METHODS: Women who were referred for IVF from April 1st, 2008 to December 31st, 2009 were enrolled sequentially in the study. A ginecological-obstetrical background questionnaire was applied and endocervical swab samples were obtained to search for CT and NG using hybrid capture and PCR. The variables studied were: age, color, education, duration of infertility, number of pregnancies and living children, history of miscarriage, ectopic pregnancy, number of sex partners, pelvic inflammatory disease (PID), pelvic surgery, manipulation of the uterine cavity, smoking, and illicit drug use. The women were distributed according to the presence/absence of confirmed chlamydia infection and descriptive analysis was employed. RESULTS: Among 176 women tested the prevalence of CT infection was 1.1% and there was no NG infection. Two thirds of the women were >30 years old, with schooling >8 years and <5 years of infertility, and 56.2% had no children. The main background data were pelvic surgery (77.8%), manipulation of the uterine cavity (62.5%) and PID (27.8%). The tubal factor was the most prevalent, 73.3% of women (from 129), 37.5% had been sterilized, 35.8% had not been sterilized, and other factors had a prevalence <30%. CONCLUSIONS: CT and NG infections had a low prevalence in this sample. Studies at other centers in the country are needed to confirm the prevalence of infection in this particular group of infertile women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):209-214
DOI 10.1590/S0100-72032012000500004
PURPOSE: To assess the prevalence of bacterial vaginosis and to compare the accuracy of testing pH and KOH with the Nugent gradient, the gold standard for the diagnosis of bacterial vaginosis (BV) in asymptomatic and symptomatic pregnant women at low risk. METHODS: We conducted a cross-sectional study on 321 pregnant women with gestational age between 14 and 26 weeks, 218 of them asymptomatic and 103 with vaginal complaints suggestive of bacterial vaginosis. All women were assessed by the criteria of Nugent and subjected to the measurement of vaginal pH and to the 10% KOH test. The Kappa coefficient was used to evaluate the methods in terms of diagnostic agreement. RESULTS: Most patients were adolescents (mean age 21.0±5.6 years), nulliparous and mulattos. The prevalence of bacterial vaginosis was 33.3% as estimated by the pH and KOH method and 35.5% by the Nugent method. Excellent agreement of the methods was found among asymptomatic pregnant women, with 72.5% of them showing negative results to both tests, which resulted in a high Kappa coefficient (k=0.82). The group of symptomatic women showed 49.5% positivity to both diagnostic methods, with excellent agreement (k=0.74). CONCLUSION: The prevalence of bacterial vaginosis determined by both the pH and KOH method and the Nugent score was high. The pH and KOH method can diagnose bacterial vaginosis as accurately as the Nugent criterion.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):209-214
DOI 10.1590/S0100-72032012000500004
PURPOSE: To assess the prevalence of bacterial vaginosis and to compare the accuracy of testing pH and KOH with the Nugent gradient, the gold standard for the diagnosis of bacterial vaginosis (BV) in asymptomatic and symptomatic pregnant women at low risk. METHODS: We conducted a cross-sectional study on 321 pregnant women with gestational age between 14 and 26 weeks, 218 of them asymptomatic and 103 with vaginal complaints suggestive of bacterial vaginosis. All women were assessed by the criteria of Nugent and subjected to the measurement of vaginal pH and to the 10% KOH test. The Kappa coefficient was used to evaluate the methods in terms of diagnostic agreement. RESULTS: Most patients were adolescents (mean age 21.0±5.6 years), nulliparous and mulattos. The prevalence of bacterial vaginosis was 33.3% as estimated by the pH and KOH method and 35.5% by the Nugent method. Excellent agreement of the methods was found among asymptomatic pregnant women, with 72.5% of them showing negative results to both tests, which resulted in a high Kappa coefficient (k=0.82). The group of symptomatic women showed 49.5% positivity to both diagnostic methods, with excellent agreement (k=0.74). CONCLUSION: The prevalence of bacterial vaginosis determined by both the pH and KOH method and the Nugent score was high. The pH and KOH method can diagnose bacterial vaginosis as accurately as the Nugent criterion.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(12):395-400
DOI 10.1590/S0100-72032011001200004
PURPOSE: To assess the prevalence of Streptococcus agalactiae, a Group B streptococcus, in pregnant women, and their possible risk factors, as well as the impact of perinatal colonization and antimicrobial susceptibility. METHODS: We evaluated 213 pregnant women from 20 weeks of gestation, regardless of risk factors, attending a tertiary teaching hospital. The technique used was a single sterile swab to collect secretions from the vaginal and perianal regions. The newly obtained samples were stored in Stuart transport medium and taken to the laboratory, where they were inoculated in Todd-Hewitt selective medium supplemented with Gentamicin (8 ug/mL) and nalidixic acid (15 ug/mL), with subsequent cultivation on blood agar plates. The materials were tested with Gram, catalase with hydrogen peroxide and CAMP (Christie, Atkins, Munch-Petersen), and results were serologically confirmed with the Streptococcal Grouping Kit, Oxoid®. The positive samples were tested for antimicrobial susceptibility. We also assessed socioeconomic, reproductive, clinical, and obstetric variables, and newborn care. Statistical analysis was performed with Epi-Info 6.04. RESULTS: The prevalence of colonization obtained by field tests was 9.8% by CAMP test, but only 4.2% by serology. The only protective factor was white skin color (p=0.01, 0.45>OR>0.94, 95%CI). There was no difference in prevalence of Group B streptococcus regarding other reproductive and obstetric variables. Infection occurred in only one of the newborns from colonized mothers; although it was revealed infection with Pseudomonas spp. High resistance to ampicillin (4/9), cephalothin (4/9), penicillin (4/9), erythromycin (3/9), clindamycin (7/9), and cloramphenicol (1/9) was detected. CONCLUSIONS: The infection rate was lower than that found in other studies, although a high rate of resistance to antibiotics commonly used for treatment was detected. Since there are no studies on the prevalence of Group B streptococcus in Ceará, we cannot perform a comparative analysis of the population, and further studies are needed with geographically similar groups to validate these results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(12):395-400
DOI 10.1590/S0100-72032011001200004
PURPOSE: To assess the prevalence of Streptococcus agalactiae, a Group B streptococcus, in pregnant women, and their possible risk factors, as well as the impact of perinatal colonization and antimicrobial susceptibility. METHODS: We evaluated 213 pregnant women from 20 weeks of gestation, regardless of risk factors, attending a tertiary teaching hospital. The technique used was a single sterile swab to collect secretions from the vaginal and perianal regions. The newly obtained samples were stored in Stuart transport medium and taken to the laboratory, where they were inoculated in Todd-Hewitt selective medium supplemented with Gentamicin (8 ug/mL) and nalidixic acid (15 ug/mL), with subsequent cultivation on blood agar plates. The materials were tested with Gram, catalase with hydrogen peroxide and CAMP (Christie, Atkins, Munch-Petersen), and results were serologically confirmed with the Streptococcal Grouping Kit, Oxoid®. The positive samples were tested for antimicrobial susceptibility. We also assessed socioeconomic, reproductive, clinical, and obstetric variables, and newborn care. Statistical analysis was performed with Epi-Info 6.04. RESULTS: The prevalence of colonization obtained by field tests was 9.8% by CAMP test, but only 4.2% by serology. The only protective factor was white skin color (p=0.01, 0.45>OR>0.94, 95%CI). There was no difference in prevalence of Group B streptococcus regarding other reproductive and obstetric variables. Infection occurred in only one of the newborns from colonized mothers; although it was revealed infection with Pseudomonas spp. High resistance to ampicillin (4/9), cephalothin (4/9), penicillin (4/9), erythromycin (3/9), clindamycin (7/9), and cloramphenicol (1/9) was detected. CONCLUSIONS: The infection rate was lower than that found in other studies, although a high rate of resistance to antibiotics commonly used for treatment was detected. Since there are no studies on the prevalence of Group B streptococcus in Ceará, we cannot perform a comparative analysis of the population, and further studies are needed with geographically similar groups to validate these results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):328-333
DOI 10.1590/S0100-72032011001100002
PURPOSE: to determine the prevalence of Chlamydia and gonorrhea in a sample of women from Curitiba. METHODS: this was a cross-sectional study with a sample of sexually active non-pregnant women aged between 16 and 23 years-old, with an intact uterus, with up to four sexual partners, without evidence of fever or purulent cervicitis, submitted to pelvic examination and PCR-based urine- testing for Chlamydia and gonorrhea. Exclusion criteria included: vaccination for HPV, vaccination history for the past 21 days, previous abnormal cytology, history of genital warts, splenectomy, immune disorders, and use of immunosuppressive drugs. An interview regarding sociodemographic and obstetric data and gynecological risk behavior for sexual transmitted diseases was applied. For statistical analysis, we used the c2 or Fisher’s exact test to assess the association between variables. RESULTS: the prevalence of Chlamydia and gonorrhea infection in the study group was 10.7 and 1.5%, respectively, and the rate of coinfection was 0.9%. No correlation was found between the age range of the volunteers, the onset of sexual activity, the number of sexual partners and of new sexual partners in the last six months, and the presence of Chlamydia or gonorrhea. In women who had vaginal discharge or ectropion, the prevalence of Chlamydia infection was two times higher than in those without such signs. CONCLUSIONS: the results of this study were similar to national studies using PCR in urine samples for the detection of Chlamydia and gonorrhea in samples of non-pregnant women of the same age groups and with the same background. Since the volunteers with more than four sexual partners and those who had purulent endocervicitis were excluded, it is believed that the prevalence of Chlamydia and gonorrhea infection could have been greater in this population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):328-333
DOI 10.1590/S0100-72032011001100002
PURPOSE: to determine the prevalence of Chlamydia and gonorrhea in a sample of women from Curitiba. METHODS: this was a cross-sectional study with a sample of sexually active non-pregnant women aged between 16 and 23 years-old, with an intact uterus, with up to four sexual partners, without evidence of fever or purulent cervicitis, submitted to pelvic examination and PCR-based urine- testing for Chlamydia and gonorrhea. Exclusion criteria included: vaccination for HPV, vaccination history for the past 21 days, previous abnormal cytology, history of genital warts, splenectomy, immune disorders, and use of immunosuppressive drugs. An interview regarding sociodemographic and obstetric data and gynecological risk behavior for sexual transmitted diseases was applied. For statistical analysis, we used the c2 or Fisher’s exact test to assess the association between variables. RESULTS: the prevalence of Chlamydia and gonorrhea infection in the study group was 10.7 and 1.5%, respectively, and the rate of coinfection was 0.9%. No correlation was found between the age range of the volunteers, the onset of sexual activity, the number of sexual partners and of new sexual partners in the last six months, and the presence of Chlamydia or gonorrhea. In women who had vaginal discharge or ectropion, the prevalence of Chlamydia infection was two times higher than in those without such signs. CONCLUSIONS: the results of this study were similar to national studies using PCR in urine samples for the detection of Chlamydia and gonorrhea in samples of non-pregnant women of the same age groups and with the same background. Since the volunteers with more than four sexual partners and those who had purulent endocervicitis were excluded, it is believed that the prevalence of Chlamydia and gonorrhea infection could have been greater in this population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(12):414-420
DOI 10.1590/S0100-72032011001200007
PURPOSE: to describe lower urinary tract dysfunctions and clinical demographic characteristics of patients with urinary symptoms. This study assessed the prevalence of diabetes mellitus and urodynamic changes in these women. METHODS: We conducted a cross-sectional, retrospective study on 578 women. The prevalence of diabetes mellitus and urodynamic diagnoses was assessed in patients with lower urinary tract dysfunctions, with their respective 95% confidence intervals. The prevalence ratios of urodynamic alterations were calculated according to the diabetes mellitus diagnoses. RESULTS: Seventy-seven patients (13.3%) had diabetes and type 2 diabetes was predominant (96.1%). Stress urinary incontinence was the most frequent urodynamic diagnosis (39%) in diabetic patients, followed by detrusor overactivity (23.4%). The prevalence of urodynamic alterations was associated with diabetes (PR=1.31; 95%CI=1.17-1.48). Changes in detrusor contractility (over- or underactivity) were diagnosed in 42.8% diabetic patients and in 31.5% non-diabetic patients. CONCLUSIONS: Diabetic women had a greater prevalence of urodynamic alterations than the non-diabetic ones. There was no association between diabetes mellitus and detrusor contractility alterations (p=0.80).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(12):414-420
DOI 10.1590/S0100-72032011001200007
PURPOSE: to describe lower urinary tract dysfunctions and clinical demographic characteristics of patients with urinary symptoms. This study assessed the prevalence of diabetes mellitus and urodynamic changes in these women. METHODS: We conducted a cross-sectional, retrospective study on 578 women. The prevalence of diabetes mellitus and urodynamic diagnoses was assessed in patients with lower urinary tract dysfunctions, with their respective 95% confidence intervals. The prevalence ratios of urodynamic alterations were calculated according to the diabetes mellitus diagnoses. RESULTS: Seventy-seven patients (13.3%) had diabetes and type 2 diabetes was predominant (96.1%). Stress urinary incontinence was the most frequent urodynamic diagnosis (39%) in diabetic patients, followed by detrusor overactivity (23.4%). The prevalence of urodynamic alterations was associated with diabetes (PR=1.31; 95%CI=1.17-1.48). Changes in detrusor contractility (over- or underactivity) were diagnosed in 42.8% diabetic patients and in 31.5% non-diabetic patients. CONCLUSIONS: Diabetic women had a greater prevalence of urodynamic alterations than the non-diabetic ones. There was no association between diabetes mellitus and detrusor contractility alterations (p=0.80).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(10):315-320
DOI 10.1590/S0100-72032011001000008
PURPOSE: to compare three methods for the detection of HPV infection and to determine the prevalence of the genotypes found. METHODS: a total of 120 cervical scrape samples from patients with cervical intraepithelial neoplasia were analyzed by the conventional polymerase chain reaction using the MY09/11 and GP05+/06+ primers, and by the Nested polymerase chain reaction. The samples were subjected to DNA amplification with the GH20 and PC04 primers (β-globin) to verify DNA quality and also by polymerase chain reaction and Nested polymerase chain reaction. The amplicons were visualized in 1.2% agarose gel stained with Blue Green Loading Dye I. Positive samples also were sequenced using the automatic DNA sequencer "MegaBACE 1000". The Χ2 and Fisher tests were used for statistical analysis with the level of significance set at 5%. RESULTS: fifteen samples were eliminated from the study because they failed to amplify the β-globin gene. Of the remaining samples, 40% (42/105) were positive using primers MY09/11, 98% (103/105) using primers GP05+/06+, and 92% (97/105) using Nested-PCR. With the MY09/11 and GP05+/06+ techniques, it was possible to obtain 100% HPV-positive samples. In this study, the prevalence of the genotypes found was 57, 23, 5, 4 and 3% for HPV genotypes 16, 18, 31, 33 and 56, respectively. HPVs 67 and 83 were present in 2%, and genotypes 6, 11, 58 and candHPV85 were present in 1% each. The prevalence of the more common genotypes (HPV 16 and 18) in this study agrees with that reported worldwide (IC95%=0.4657-0.8976). CONCLUSIONS: to obtain more reliable results, it is necessary the use of more than one primer system to detect HPV infections. We believe that the three techniques studied are important and suitable for the clinical diagnosis of HPV, when they are appropriately combined.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(10):315-320
DOI 10.1590/S0100-72032011001000008
PURPOSE: to compare three methods for the detection of HPV infection and to determine the prevalence of the genotypes found. METHODS: a total of 120 cervical scrape samples from patients with cervical intraepithelial neoplasia were analyzed by the conventional polymerase chain reaction using the MY09/11 and GP05+/06+ primers, and by the Nested polymerase chain reaction. The samples were subjected to DNA amplification with the GH20 and PC04 primers (β-globin) to verify DNA quality and also by polymerase chain reaction and Nested polymerase chain reaction. The amplicons were visualized in 1.2% agarose gel stained with Blue Green Loading Dye I. Positive samples also were sequenced using the automatic DNA sequencer "MegaBACE 1000". The Χ2 and Fisher tests were used for statistical analysis with the level of significance set at 5%. RESULTS: fifteen samples were eliminated from the study because they failed to amplify the β-globin gene. Of the remaining samples, 40% (42/105) were positive using primers MY09/11, 98% (103/105) using primers GP05+/06+, and 92% (97/105) using Nested-PCR. With the MY09/11 and GP05+/06+ techniques, it was possible to obtain 100% HPV-positive samples. In this study, the prevalence of the genotypes found was 57, 23, 5, 4 and 3% for HPV genotypes 16, 18, 31, 33 and 56, respectively. HPVs 67 and 83 were present in 2%, and genotypes 6, 11, 58 and candHPV85 were present in 1% each. The prevalence of the more common genotypes (HPV 16 and 18) in this study agrees with that reported worldwide (IC95%=0.4657-0.8976). CONCLUSIONS: to obtain more reliable results, it is necessary the use of more than one primer system to detect HPV infections. We believe that the three techniques studied are important and suitable for the clinical diagnosis of HPV, when they are appropriately combined.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):188-195
DOI 10.1590/S0100-72032011000800004
PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):188-195
DOI 10.1590/S0100-72032011000800004
PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):196-200
DOI 10.1590/S0100-72032011000800005
PURPOSE: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. METHODS: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urinary tract infection. The following exclusion criteria were considered: presence of clinical signs such as fever, dysuria, vesical tenesmus, lumbar pain, history of active genital bleeding or loss of amniotic fluid, use of antimicrobial agents in the 30 days prior to sample collection, and refusal to participate in the project. The presence of single pathogen bacterial colonization ≥10(5) CFU/mL in the urine sample obtained from the middle jet was considered to be a dependent variable. The predictive factors evaluated were as follows: age, race, marital status, schooling, gestational age, hypertension, anemia, vaginal infection, sickle cell trait and previous history of urinary tract infection, urinary symptoms related to the lower urinary tract (frequency, urgency and nocturia) and data obtained from the urine summary (leukocyturia, increased bacterial flora, hematuria, proteinuria, and presence of nitrite). Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) software version 13.0 and the level of significance was set at p<0.05. Prevalences were expressed as percentage, and the confidence interval considered was 95% (95%CI). RESULTS: The prevalence of asymptomatic bacteriuria was 12.3% (95%CI=8.3-16.3). E. coli was the most frequent etiologic agent (59.4%). Logistic regression indicated that urgency to void (OR=5.99; 95%CI=2.20-16.31; p<0.001); leukocyturia (OR=2.85; 95%CI=1.04-7.83; p=0.042) and increased bacterial flora (OR=10.62; 95%CI=3.95-28.56; p<0.001) were independent predictors of asymptomatic bacteriuria. CONCLUSION: The prevalence of asymptomatic bacteriuria in the studied population was high. The prediction score created for the final logistic regression model has an accuracy of 91.9% for bacteriuria.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):196-200
DOI 10.1590/S0100-72032011000800005
PURPOSE: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. METHODS: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urinary tract infection. The following exclusion criteria were considered: presence of clinical signs such as fever, dysuria, vesical tenesmus, lumbar pain, history of active genital bleeding or loss of amniotic fluid, use of antimicrobial agents in the 30 days prior to sample collection, and refusal to participate in the project. The presence of single pathogen bacterial colonization ≥10(5) CFU/mL in the urine sample obtained from the middle jet was considered to be a dependent variable. The predictive factors evaluated were as follows: age, race, marital status, schooling, gestational age, hypertension, anemia, vaginal infection, sickle cell trait and previous history of urinary tract infection, urinary symptoms related to the lower urinary tract (frequency, urgency and nocturia) and data obtained from the urine summary (leukocyturia, increased bacterial flora, hematuria, proteinuria, and presence of nitrite). Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) software version 13.0 and the level of significance was set at p<0.05. Prevalences were expressed as percentage, and the confidence interval considered was 95% (95%CI). RESULTS: The prevalence of asymptomatic bacteriuria was 12.3% (95%CI=8.3-16.3). E. coli was the most frequent etiologic agent (59.4%). Logistic regression indicated that urgency to void (OR=5.99; 95%CI=2.20-16.31; p<0.001); leukocyturia (OR=2.85; 95%CI=1.04-7.83; p=0.042) and increased bacterial flora (OR=10.62; 95%CI=3.95-28.56; p<0.001) were independent predictors of asymptomatic bacteriuria. CONCLUSION: The prevalence of asymptomatic bacteriuria in the studied population was high. The prediction score created for the final logistic regression model has an accuracy of 91.9% for bacteriuria.