Maternal urinary tract infection and adverse fetal outcomes.

The relationship of acute urinary tract infection occurring during pregnancy and the incidence of adverse fetal outcomes was examined with the use of birth certificate data from Washington state for the years 1980 and 1981. The two-year fetal mortality rate among urinary tract infection-associated pregnancies was found to be 17.9 per thousand livebirths, 2.4 times the rate for the state as a whole. Low birth weight newborns and small for gestational age newborns were, respectively, 2.04 and 1.57 times more frequent in urinary tract infection-associated pregnancies compared to controls. These estimates of risk were unchanged when adjusted for maternal age, race, and past obstetric history. The risk of prematurity in women with urinary tract infection and no history of fetal loss was 2.4 times the control risk. Sepsis was rare in both the urinary tract infection and control groups. These results add to the evidence implicating maternal urinary tract infection as a threat to fetal well-being.