THE INFLUENCE OF TRIMESTERS ON PROGESTERONE AND Escherichia coli URINARY TRACT INFECTION IN PREGNANT WOMEN ATTENDING MOI TEACHING AND REFERRAL HOSPITAL ANTENATAL CLINIC

Abstract

Urinary tract infections (UTIs) are common health problem among pregnant women. The UTIs presents as either symptomatic or asymptomatic bacteriuria, which is a major predisposing factor for pyelonephritis that is linked to obstetrical complications including preterm labor and low birth weight of infants. The UTIs are also known to be common cause of maternal and fetal morbidity and mortality. The asymptomatic and symptomatic pregnant women are predisposed to anatomical and physiological changes imposed on the urinary tract by the progesterone hormone leading to urinary stasis, which facilitates bacterial colonization and ascending infection to kidneys. In pregnancy, the maternal immune system is also lowered hence promotes the growth of bacteria in the urinary system. Therefore, the present study aimed at determining the occurrence of E. coli in the urinary system and correlate to progesterone hormone levels among pregnant women attending antenatal clinics (ANC) at Moi Teaching and Referral Hospital. A cross-sectional study design and probability sampling method were used to collect 78 blood and urine samples at intervals for 60 working days from pregnant women who met the inclusion criteria and consented to the study. The urine samples were cultured in CLED media while the blood was separated and plasma aliquoted for progesterone estimation using ELISA method. The culture withthebacteriacolony count of more than 105was identifiedusing biochemical tests and gram stain.The cultures showed that the most abundant bacterial organism isolated in urine from the participating women was E. coli (9%). There were exponential increases in progesterone levels for the participating pregnant women in trimester three compared to other trimesters, however, these increases seemed to have occurred independently of bacterial infections. The more affected age-group category were women between 30-39years in trimester three, suggesting that the colonization of the genital track occurred more in older women probably due to lower pH in their genital track compared to the genital track of younger women which are more acidic.The levels of progesterone of the pregnant women in the third trimester corresponded withthe highest number of E.coli causing UTI.In conclusion,the study showed that progesterone levels increase with trimester and the most prevalent bacteriawas E. colieven though age and increase in progesterone levelshad no significant impact on E. coli infection.