Asymptomatic Bacteriuria in Pregestational Diabetic Pregnancies and the Role of Group B Streptococcus

 

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ABSTRACT

We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A_1c values compared with diabetics without ASB (8.31 ± 1.89 versus 7.31 ± 1.84, p = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas.

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Joseph J ApuzzioM.D. 

Department of Obstetrics, Gynecology and Women's Health, Division of Maternal-Fetal Medicine

UMDNJ-New Jersey Medical School, 185 South Orange Avenue, MSB E 506, Newark, NJ 07101

Email: joseph.apuzzio@umdnj.edu