, Volume 8, Issue 1, pp 8-12

Bacteriuria in pregnancy: A comparison of Bangladeshi and Caucasian women

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During a 5-year period all urine culture results from pregnant Caucasian and Bangladeshi women booked for confinement at the Royal London Hospital, London, UK, were reviewed to determine race-specific rates of bacteriuria. The results showed that the overall prevalence of bacteriuria in the Caucasian group was 6.3% compared to 2.0% for the Bangladeshi women. Caucasian women were found to be at significantly greater risk across all pregnancy outcome and history categories, with the greatest risk observed in grand multiparous women (RR: 4.7, 95% CI: 2.8–8.3). Pregnancies that resulted in preterm delivery showed a strong association of bacteriuria in Caucasian women which was not seen in the Bangladeshi women (RR: 4.4, 95% CI: 2.0–8.7). The data suggest that Caucasian women have a significantly higher prevalence of bacteriuria in pregnancy than their Bangladeshi neighbors. Differences in hygiene practices and clothing may explain the observed differences in the bacteriuria rates.

Editorial Comment: The authors present a well designed study looking at the incidence of bacteriuria during pregnancy among Caucasian and Bangladeshi women. Their results show a significantly lower prevalence of bacteriuria among Bangladeshi women. What this means clinically is unknown. Although a definite link between symptomatic urinary tract infection and preterm labor has been reported, the significance of asymptomatic bacteriuria remains unclear. In this study Bangladeshi women were more apt to deliver preterm and low-birthweight babies than Caucasian women, in spite of their lower incidence of bacteriuria. Among other factors, the authors suggest that the lower prevalence of bacteriuria among Bangladeshi women may be related to the common practice of ablution following micturition and defecation. Perhaps all women should be counseled to adopt this hygienic act in an effort to reduce the risk of urinary tract infection.