UTI During Pregnancy: Causes, Symptoms, Risks And Treatment

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A urinary tract infection (UTI) is a bacterial infection that causes inflammation in the urinary tract. Escherichia coli (E.coli) is the most common bacteria responsible for the condition (1) (2). UTI during pregnancy is common, with about eight percent incidence (3) due to hormonal changes and urinary stasisⁱUrinary retention due to incomplete emptying of the bladder from increased pressure of the growing uterus (2). The infection can be effectively treated with antibiotics upon early diagnosis. But, if left untreated, it can cause severe complications for the mother and the baby. Learn all about UTIs in pregnancy and ways to help prevent complications.

Risk Of UTIs By Pregnancy Trimester

The risk of UTIs is the highest between weeks six and 24 due to the changes in the urinary tract (1). According to the Centers for Disease Control and Prevention (CDC), 41% of UTIs occur in the first trimester, followed by the second with half the occurrences and the third with 11.8% (3).

Symptoms Of UTI In Pregnancy

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UTIs during pregnancy may either be symptomatic or asymptomatic. According to performed research, two to seven percent of pregnant women with UTIs are asymptomatic (2). The common symptoms of UTI  during pregnancy include (1):

• Burning sensation, discomfort, or pain while peeing
• Frequent urgency to urinate with a complete inability to hold the urge
• Disturbed sleep due to an increased frequency of urination
• Passing of blood or mucus with urine
• Lower abdominal pain or cramps
• Urinary incontinenceⁱUnintentional urine leakage due to the loss of bladder control accompanied by fever, chills, and sweats
• Sudden increase or decrease in the amount of urine
• Foul-smelling urine with a cloudy appearance
• Nausea, vomiting, and back pain if the infection affects the kidneys
• Painful sexual intercourse

You should call your doctor upon experiencing any of the above symptoms.

Causes Of UTI In Pregnancy

Although UTI may happen to pregnant and non-pregnant individuals, certain factors may increase the risk of its occurrence in pregnancy. Some common causes are:

• Pregnancy hormone:Progesterone relaxes the smooth muscles and causes urinary tract dilation. This enables urinary stasis by helping prevent complete emptying of the bladder while peeing (2) (4).
• Uterus size: The growing uterus puts pressure on the bladder, causing urine retention while peeing (5). Urinary retention leads to bacterial growth (4).

Caution

The longer the urine stays stagnant in the body, the more time it gives bacteria to grow (4).

• Hygiene practices: The common UTI-causing bacteria E. coli and other microorganisms are present in the stool (5). Thus, you may increase the risk of contracting UTI if you wipe yourself from back to front after defecating (4).
• Underlying conditions: Some conditions, such as sickle cell anemiaⁱAn inherited blood disorder that alters the morphology of red blood cells and gestational diabetesⁱPregnancy-induced diabetes put you at an increased risk for UTI as these conditions lower the body’s disease-fighting capacity (4).

UTI Diagnosis In Pregnancy

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The doctor may begin with your health history and physical examination (6). Then, they may recommend a urine test to look for disease-causing bacteria and white and red blood cells (5). Since UTIs are common in pregnancy, a urine culture test is usually a part of the prenatal checkups carried out in the first prenatal visit or at 12 to 16 weeks pregnant (7). Asymptomatic UTI needs to be treated with antibiotics if the culture shows a high number of bacteria.

Did you know?

Not all urine tests during pregnancy are for checking UTIs. In the third trimester, urine samples may be taken to check for gestational diabetes, high blood pressure, and STDs such as chlamydiaⁱA sexually transmitted disease caused by a bacteria called chlamydia trachomatis (C. trachomatis). and gonorrheaⁱA sexually transmitted disease caused by a bacteria called Neisseria gonorrhoeae. (4).

Treatment Of UTI In Early Pregnancy

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UTI in early pregnancy is commonly treated with a three- to seven-day course of oral antibiotics such as amoxicillin, ampicillin, cephalosporins, nitrofurantoin, and trimethoprim-sulfamethoxazole. The doctor may prescribe medications that are safe for both the mother and the developing fetus, considering the gestational age and importance of prenatal care. However, if the infection recurs, you may be prescribed a longer course of lower-dose antibiotics while pregnant (2) (4). This is usually combined with urine alkalinizer and plenty of fluid intake orally.

If the infection spreads to the kidneys, causing pyelonephritis, the antibiotics need to be administered intravenously at the hospital (4).

Experts say

According to ACOG, the commonly used UTI antibiotics sulfonamides and nitrofurantoin may be used after ruling out other antimicrobial therapies since the former may increase the risk of congenital disabilitiesⁱStructural or functional anomalies present at birth (3).

Complications Of UTI In Pregnancy

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UTI may cause complications in pregnancy if left untreated in the early stages. Some of them include (1) (5):

• Kidney infections, which may lead to premature labor and low birth weight
• Anemia
• Prolonged severe infection

In extreme cases, untreated UTI may cause fetal death (5). These complications can be prevented if you are mindful of the early symptoms.

Quick fact

Pyelonephritis, or kidney infection caused by UTI, is considered the most severe health condition in pregnancy (2).

Prevention Of UTI In Pregnancy

Although it may not be possible to prevent UTI completely, you may lower your risks by following these measures (1):

• Drink ten to twelve glasses of water each day to maintain proper hydration
• Avoid refined foods, alcohol, sugar, caffeine, and fruit juices
• Consume unsweetened cranberry juice regularly

An anonymous blogger and mother of two shares how cranberry supplements helped her prevent UTI during her second pregnancy. She says, “Well, when I was pregnant with Giuliana, I had a UTI almost constantly & had to be on antibiotics quite a bit. It was awful. When I was seven months pregnant, I got a kidney infection & had to be hospitalized. It was so painful!! and very scary. So, this time around, I am doing everything I can to prevent that from happening again. So far, it (cranberry supplement) has helped tremendously! I have not had a problem yet (i)!”

• Take vitamin C, zinc, and beta-carotene supplements to boost your immune system
• Do not hold the urge to pee
• Clean your genital area by blotting it dry and avoiding rubbing
• Ensure to pee before and after sexual intercourse
• Prefer cotton underwear and change them regularly
• Avoid harsh soaps, douchesⁱWashing or cleaning the inside of the vagina with water or mixture of fluids. , antiseptic creams, and feminine hygiene products
• Avoid tight-fitting pants
• Do not soak yourself in a bathtub for more than 30 minutes or more than twice a day

Infographic: Tips To Help Prevent UTI In Pregnancy

Although urinary tract infection in pregnancy is seldom alarming if treated on time, its symptoms can be uncomfortable and interfere with a healthy and happy pregnancy. This infographic discusses useful measures and tips to help you prevent contracting the infection and thereby avoid possible complications. Scroll down to learn more about it.

Illustration: Momjunction Design Team

Illustration: UTI During Pregnancy: Causes Symptoms Risks And Treatment

Image: Stable Diffusion/MomJunction Design Team

UTI during pregnancy is common and can harm both the mother and the fetus. However, it can be avoided. Learn some advice on how to prevent UTI while pregnant in this video.

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Reviewer Author Editor Fact Checker

Dr. Swati ChitnisMS, DNB

Dr. Swati Chitnis is a gynecologist and endoscopic surgeon with over 8 years of experience. She did her bachelor in medicine at BJ Medical College & Sassoon Hospital, Pune, India  and MS at the prestigious King Edward Memorial Hospital, Mumbai.

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Aneesha AmonzMSc

Aneesha holds a Bachelor's degree in Biotechnology from USTM, Meghalaya and Master’s degree in Applied Microbiology from VIT, Vellore. With two years of experience, she has worked on different research projects in the field of Food Sciences.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction.

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