Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
Department of Obstetrics & Gynecology, Women's Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Urol. 2019 May 30;19(1):43. doi: 10.1186/s12894-019-0454-8.
Urinary tract infection (UTI) is a common clinical problem in pregnant women. Bacteriuria in pregnancy without antibiotic treatment could result in complications. This study aims to investigate the etiology and prevalence of UTI and asymptomatic bacteriuria (ASB) in pregnant women in Iran.
This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To avoid bias, all steps of the study were carried out independently by two researchers. We conducted a comprehensive search on all the related literature in national databases, including IranDoc, SID, Barakat Knowledge Network System, RICST, Magiran, Iranian National Library and international databases, including Scopus, Embase, Science Direct, PubMed/ Medline, Cochrane Library, Web of Sciences, EBSCO, as well as Google Scholar search engine until June 2018. After considering the inclusion/exclusion criteria and qualitative evaluation, studies were analyzed based on random effects model using Comprehensive Meta-Analysis Software Version 2.
In 31 studies with a sample size of 20,309, the prevalence of ASB in pregnant Iranian women was estimated to be 8.7% (95%CI: 7.2-10.4). The lowest and highest prevalence of ASB were observed in the third trimester (6.1% [95%CI: 2.1-16.4]) and first trimester (11.7% [95%CI: 7.9-16.9]), respectively. Subgroup analysis of the prevalence of ASB based on geographical region (P = 0.002) and province (P < 0.001) was significant but for the quality of studies (P = 0.51) was not significant. In 17 studies including 48,731 pregnant women, the prevalence of UTI was estimated to be 9.8% (95%CI: 7.6-12.5). The test for subgroup differences of prevalence of UTI for province (P < 0.001) was significant but for geographical region (P = 061) and quality of studies (P = 0.11) was not significant. Meta-regression model for the prevalence of UTI and ASB in pregnant women in Iran based on year of the studies was significant (P < 0.001). The most common microorganism involved in the etiology of UTI (61.6% [95%CI: 51.6-70.7]) and ASB (63.22% [95%CI: 51.2-73.8]) was E. coli.
UTI and ASB are prevalent in pregnant women in Iran. Therefore, UTI screening is essential in pregnant women. The most common microorganism involved in the etiology of UTI and ASB in pregnant women in Iran is E.coli.
尿路感染（UTI）是孕妇常见的临床问题。未经抗生素治疗的妊娠菌尿可能导致并发症。本研究旨在调查伊朗孕妇 UTI 和无症状菌尿（ASB）的病因和流行情况。
本荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。为了避免偏倚，研究的所有步骤均由两名研究人员独立进行。我们在国家数据库（包括 IranDoc、SID、Barakat Knowledge Network System、RICST、Magiran、伊朗国家图书馆）和国际数据库（包括 Scopus、Embase、Science Direct、PubMed/Medline、Cochrane Library、Web of Sciences、EBSCO 以及 Google Scholar 搜索引擎）上对所有相关文献进行了全面检索，检索时间截至 2018 年 6 月。在考虑纳入/排除标准和定性评估后，使用 Comprehensive Meta-Analysis Software Version 2 基于随机效应模型对研究进行分析。
在纳入的 31 项研究中，共有 20309 名样本，伊朗孕妇 ASB 的患病率估计为 8.7%（95%CI：7.2-10.4）。ASB 的最低和最高患病率分别出现在妊娠晚期（6.1%[95%CI：2.1-16.4]）和妊娠早期（11.7%[95%CI：7.9-16.9]）。基于地理位置（P=0.002）和省份（P<0.001）的 ASB 患病率亚组分析具有统计学意义，但基于研究质量（P=0.51）的亚组分析无统计学意义。在纳入 48731 名孕妇的 17 项研究中，UTI 的患病率估计为 9.8%（95%CI：7.6-12.5）。UTI 患病率的亚组差异检验（P<0.001）具有统计学意义，但地理位置（P=0.61）和研究质量（P=0.11）的亚组差异检验无统计学意义。基于研究年份的伊朗孕妇 UTI 和 ASB 患病率的元回归模型具有统计学意义（P<0.001）。参与 UTI（61.6%[95%CI：51.6-70.7]）和 ASB（63.22%[95%CI：51.2-73.8]）病因的最常见微生物是大肠杆菌。
UTI 和 ASB 在伊朗孕妇中较为常见。因此，对孕妇进行 UTI 筛查至关重要。参与伊朗孕妇 UTI 和 ASB 病因的最常见微生物是大肠杆菌。
