Weak Recommendation to Screen for Bacteriuria in Pregnancy
TUESDAY, July 31, 2018 -- Very low-quality evidence supports screening for elevated bacteria levels in urine during the first trimester for non-symptomatic pregnant women, according to a clinical guideline published in the July 9 issue of CMAJ, the journal of the Canadian Medical Association.
Ainsley Moore, M.D., and colleagues from the Canadian Task Force on Preventive Health Care, conducted a systematic review and engaged 34 women who were either pregnant or of childbearing age to guide the development of the updated recommendations.
The Task Force gives a weak recommendation in favor of screening pregnant women for asymptomatic bacteriuria with urine culture once during the first trimester. The Task Force found scant and very low-quality evidence regarding harms associated with screening and treatment of asymptomatic bacteriuria in pregnancy. They discovered patient values and preferences regarding screening varied and were influenced by individual perspectives regarding the small potential benefit of antibiotic use as well as potential harms associated with antibiotic use in pregnancy. Women at increased risk of urinary tract infections in pregnancy should follow guidance for populations at higher risk.
"It ultimately comes down to patient preferences and a discussion between the clinician and patient to determine these [screening preferences]," Brett Thombs, Ph.D., chair of the Task Force, said in a statement.
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Posted: July 2018