Predictors of symptomatic urinary tract infection after 20 weeks' gestation

Lisa M. Pastore, David A. Savitz, John M. Thorp, Gary G. Koch, Irva Hertz-Picciotto, Debra E. Irwin

Research output: Contribution to journalArticle

30 Scopus citations


OBJECTIVE: To identify predictors of symptomatic urinary tract infection (UTI) after 20 weeks' gestation. STUDY DESIGN: A retrospective cohort analysis was conducted of all deliveries at three North Carolina hospitals between 1990 and 1993. A total of 7403 deliveries remained after exclusions (pre-pregnancy diabetes, HIV-positive, structural urologic abnormalities, no prenatal care) and restrictions (black or white race, county of residence). Cystitis and pyelonephritis were identified by clinician diagnosis. Multiple logistic regression was conducted. RESULTS: Prior UTIs (both before and earlier in pregnancy), nonprivale clinics, and a history of chlamydia (white women only) doubled the risk of symptomatic UTIs after 20 weeks' gestation. The strongest predictor of pyelonephritis was prior antenatal UTIs (adjusted incidence odds ratio = 5.3,95% confidence interval of 2.6-11.0), followed by less education (<12 years), a history of chlamydia, nonprivate clinics, illicit drug use, sickle cell hemoglobinopathy, and being unmarried. CONCLUSION: Medical history and demographic factors predict cystitis and pyelonephritis after 20 weeks' gestation. Prospective studies of pyelonephritis predictors and screening strategies are warranted.

Original languageEnglish (US)
Pages (from-to)488-493
Number of pages6
JournalJournal of Perinatology
Issue number7
StatePublished - Oct 1999
Externally publishedYes


ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Pastore, L. M., Savitz, D. A., Thorp, J. M., Koch, G. G., Hertz-Picciotto, I., & Irwin, D. E. (1999). Predictors of symptomatic urinary tract infection after 20 weeks' gestation. Journal of Perinatology, 19(7), 488-493.