Urinary Tract Infection (UTI) in Pregnancy – Causes, Symptoms & Treatment

Urinary tract infections (UTIs) are common in women. About one in five women develop UTI at some point in their lives. However, pregnancy increases the chances of getting the infection as a woman’s body goes through rapid changes, which can provide a conducive environment for intestinal and gastrointestinal bacteria to enter the urinary tract. Urine infection in early pregnancy is fairly common. A woman has a higher chance of developing a UTI between the 6^th and the 24^th week of pregnancy. It’s crucial to understand the causes and symptoms of urinary tract infections in pregnancy. Read on to learn more about UTIs during pregnancy.

What Is Urinary Tract Infection?

A urinary tract infection is an inflammation of the urinary tract due to bacteria. Although it is commonly associated with a bladder infection, it may happen in any part of your urinary tract (1). This includes the kidneys which make the urine, the ureter which carries the urine to the bladder, the bladder where your urine accumulates and the urethra which carries urine out of your body.

UTIs are commonly caused due to the bacteria from the skin, vagina and rectal area, which enter into the urinary tract. There are different types of UTIs:

• Bladder Infection or Cystitis: This happens when the bacteria accumulate and multiply in the bladder, causing inflammation. It is common in women between 20 and 50 years of age who are sexually active.
• Kidney Infection or Pyelonephritis: When the bacteria travel up the urinary tract and into the kidneys, they may infect one or both kidneys. A kidney infection is a serious complication during pregnancy. The infection may enter your bloodstream and cause life-threatening complications as well. It also increases the risk of preterm labour and low birth weight and has been linked to a higher risk of foetal mortality.
• Asymptomatic Bacteriuria: If you have no symptoms, even though there are bacteria in your urinary tract, it is called asymptomatic bacteriuria. When you are pregnant, if this is not treated, it can increase the risk of kidney infection. This is why doctors perform a urine test on your routine prenatal check-ups.

Why Are UTIs Common During Pregnancy?

Pregnancy hormones and your growing uterus make you more likely to get a urinary tract infection during pregnancy. The progesterone hormone causes the ureters to dilate and slow the flow of urine (2). Your expanding uterus also presses against the ureters making the flow of urine difficult. Your bladder will also have trouble expelling all the urine out of your body during pregnancy. Some of it may even flow back into the kidneys due to a condition called reflux. These changes increase the chances of bacteria multiplying and causing an infection. Moreover, during pregnancy, your urine is less acidic and has more glucose in it, giving bacteria a chance to multiply more freely.

What Causes Urine Infection During Pregnancy?

Some of the common reasons for urinary tract infection during pregnancy are (3):

• Changes in Your Body: Changes in the body, such as increasing levels of hormones and growing uterus, cause a slower flow of urine in the ureters due to the pressure on the bladder. This also leads to an inability to expel urine completely from the bladder. All of these changes can contribute to a urinary tract infection during pregnancy.
• Bowel Bacteria: One of the common reasons for a urinary tract infection is bacteria from the bowel. As the distance between the urethra and the rectum in women is very short, it is easier for bacteria like E.coli to travel into the urinary tract.
• Sex During Pregnancy: Although sex during pregnancy is healthy, it may increase your chances of a UTI. The bacteria in your vagina get pushed into the urethra, leading them into the urinary tract. Peeing before and after sex and rinsing the region after sex can help prevent UTIs.
• Group B Streptococcus: These bacteria are commonly found in the intestinal tract and can lead to infections that cause painful urination during pregnancy.

In addition to these causes, if you have diabetes, have given birth to several children, are obese, or have a history of recurrent UTI, you may be at a higher risk of developing a UTI.

Signs and Symptoms of Urinary Tract Infection During Pregnancy

Here are some of the symptoms of urinary tract infection in pregnancy that you may experience (4).

• Pain or burning sensation during urination
• Frequent need to urinate
• A feeling of urgency as you urinate
• Painful cramps in the lower abdomen
• Blood or mucus in the urine
• Fever, sweats and chills
• Incontinence or leaking of urine
• Pain during sex
• Soreness or tenderness in the bladder area
• Foul-smelling urine
• Urine looks cloudy
• Back pain, nausea and vomiting (signs of kidney infection)

How Is UTI Diagnosed in Pregnancy?

UTI is diagnosed with a urine culture (5). The urine is analysed for the presence of bacteria, and you will be given pregnancy-safe antibiotics if you have an infection. Sometimes, the infection can last more days if its severe or has resistance bacteria, but the antibiotics won’t be given for more than 10 days.

Complications of Urinary Tract Infection in Pregnancy

Urinary tract infections (UTIs) are common during pregnancy and, if left untreated, can lead to serious complications for both the mother and the baby. Understanding the complications and making timely diagnoses and treatment is crucial to prevent adverse outcomes (6).

• Kidney Infections (Pyelonephritis): Untreated UTIs can progress to kidney infections, which are life-threatening for both the mother and the baby. Symptoms may include high fever, back pain, and nausea.
• Preterm Labour: UTIs, particularly kidney infections, are associated with an increased risk of preterm labour, which can lead to complications for the newborn.
• Low Birth Weight: Babies born to mothers with untreated UTIs are at a higher risk of being born with low birth weight, which can affect their overall health and development.
• Recurrent Infections: If not treated effectively, UTIs may recur even after delivery, posing ongoing health risks for the mother.
• Maternal Sepsis: Severe infections can lead to sepsis, a life-threatening condition that requires immediate medical intervention.
• Increased Risk of Hypertension: UTIs during pregnancy have been linked to an increased risk of gestational hypertension or preeclampsia, which can complicate pregnancy.
• Amniotic Fluid Infections: UTIs can sometimes lead to infections of the amniotic fluid, increasing the risk of complications for the baby.

How to Treat Bladder Infection During Pregnancy

If you have a bladder infection during pregnancy, you will be provided with antibiotics to relieve the symptoms. It is important that you complete the course of antibiotics even though your pain is alleviated in a few days. Bladder infection and pregnancy are closely linked, as hormonal changes and the growing uterus can increase the risk of UTIs, making timely diagnosis and treatment essential to protect both the mother and the baby.

Are There Any Natural Remedies for UTI?

There are several natural home remedies for UTI that you can try under directions from a health expert. Some of them include:

• Vitamin C: Eating foods and fruits rich in Vitamin-C such as oranges can make your urine more acidic and inhibit the growth of bacteria.
• Clove Oil: Clove oil has antifungal, antimicrobial and antiviral properties which can help prevent the bacterial formation in the urinary tract.
• Oregano Oil: Oregano oil also has anti-bacterial properties and can inhibit the growth of UTI-causing bacteria like E.coli. However, it must be used only after approval from the doctor to avoid any pregnancy complications.

How Can You Prevent UTI During Pregnancy?

Following these simple steps can help you prevent a UTI (7):

• Drink Plenty of Water: Stay hydrated and drink at least eight to twelve glasses of water every day. This can help flush out the bacteria from your urethra.
• Pee When You Feel Like it: Do not hold your pee or ignore the urge to pee.
• Wipe Front to Back: Always wipe from the front to the back in order to prevent bacteria from travelling from the rectum to your urethra.
• Maintain Genital Hygiene: Use mild soap and water to wash your genital area thoroughly.
• Avoid Using Feminine Hygiene Products: Do not use sprays, douches, and powders that can irritate your genital area and urethra. An irritated genital area provides a better breeding ground for bacteria.
• Avoid Wearing Tight Panties: Do not wear panties that fit too tightly and wear cotton underpants if you can. This will keep your genital area dry and prevent bacteria from multiplying. Also, change your underwear every day.
• Avoid Bathtubs: Try to use a shower instead of bathtubs as the latter can allow bacteria from the anus to enter the urethra. If you use a bathtub, ensure that you limit your time in it.

When to Call the Doctor

Pregnant women and UTIs often go hand in hand due to physiological changes during pregnancy, making it crucial to monitor for symptoms and seek prompt treatment to avoid complications. Here are key signs and symptoms that indicate you should call your doctor:

• Burning or pain during urination
• Frequent urge to urinate
• Cloudy, bloody, or strong-smelling urine
• Pelvic pain or pressure
• Fever or chills
• Back pain or flank pain
• Nausea or vomiting
• General malaise or fatigue

FAQs

1. Can UTIs during pregnancy lead to miscarriage?

While UTIs are not a direct cause of miscarriage, severe infections like pyelonephritis can increase the risk of complications such as preterm labour or low birth weight, which may indirectly contribute to pregnancy loss in rare cases. Prompt treatment minimises this risk.

2. Can a UTI during pregnancy cause gestational diabetes or worsen blood sugar control?

While UTIs do not directly cause gestational diabetes, they can make blood sugar levels harder to manage in women who already have the condition. Infections can increase insulin resistance, so proper UTI treatment is crucial for maintaining stable blood sugar levels.

3. Can a UTI during pregnancy lead to postpartum complications, such as endometritis?

Yes, untreated UTIs during pregnancy can increase the risk of postpartum infections, including endometritis (infection of the uterine lining). This is more likely if the UTI was severe or led to a kidney infection before delivery.

This was all about UTI and pregnancy. UTIs can be prevented with proper hygiene, hydration, and care. This way, you can stay clear of any risks that it may pose to your pregnancy. However, if you notice any signs of a urinary infection, it is best to seek medical help from your healthcare expert to alleviate the symptoms. Also, ensure that you go for regular check-ups and get a urine culture performed to keep a check on any urine infection that could be potentially dangerous.

References/Resources:

1. Nationwide Children’s Hospital – Urinary Tract and Kidney Infections in Pregnancy 

2. National Library of Medicine – Urinary Tract Infection in Pregnancy 

3. WFMC Health – Why Are UTIs Common During Pregnancy?

4. Mayo Clinic – Urinary tract infection (UTI) 

5. American Family Physician – Screening for Asymptomatic Bacteriuria in Adults: Recommendation Statement 

6. American Pregnancy Association – Urinary Tract Infection – UTI During Pregnancy

7. The University of New Mexico – What to Know About Urinary Tract Infections During Pregnancy 

Also Read:

Bladder Pain when Pregnant
Rib Pain while Pregnant
Vaginal Infections During Pregnancy
Most Common Pregnancy Pains and Their Solutions

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