Perinatal risk for mortality and mental retardation associated with maternal urinary-tract infections.

OBJECTIVE

The researchers analyzed the relationship between fetal exposure to maternal urinary tract infections (UTIs) and mental retardation or developmental delay and fetal death.

STUDY

DESIGN

A retrospective cohort design was used to explore the risk for fetal death and mental retardation or developmental delay associated with exposure to maternal UTI during pregnancy.

POPULATION: Matched maternal-child pairs from the National Collaborative Perinatal Project (NCPP) from the decades of 1960 and 1970 were compared with a previous analysis of the South Carolina Medicaid Reimbursement System (Medicaid) for 1995-1996. Both data sets are representative of poor women and their children.

OUTCOMES MEASURED: The outcomes measured were fetal death and mental retardation or developmental delay in the live-born children.

RESULTS

There was an increased relative risk (RR) for mental retardation or developmental delay in the third trimester of pregnancy (RR=1.40; 95% confidence interval [CI], 1.01-1.95) in the NCPP, and there was a similar risk in the Medicaid data. The third trimester relative hazard for fetal death associated with maternal UTI was 2.23 (95% CI, 1.40-3.55).

CONCLUSIONS

The findings support an association between maternal UTI and fetal death and mental retardation or developmental delay. These results confirm the importance of diligent diagnosis and treatment of maternal UTI by prenatal care providers.