Keywords
pregnancy
microbiological profile
antimicrobial resistance
PRISMA
meta-analysis
How to Cite
Abstract
Introduction
Urinary tract infection (UTI) during pregnancy is a major cause of maternal and fetal morbidity worldwide.
Purpose
This study evaluated the global burden, uropathogen spectrum, and methodological heterogeneity of UTIs among pregnant women.
Methods
Following PRISMA guidelines, a systematic search was conducted across PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, ScienceDirect, Cairn, and PsycINFO for observational studies (2016–2026) reporting UTI prevalence and microbiological distributions in pregnant populations. Meta-analyses were executed using Comprehensive Meta-Analysis (CMA v4.0) under a random-effects model.
Results
Meta-analysis of 55 studies (N = 101,232) estimated the pooled global UTI prevalence at 13.2% (95% CI [12.8, 13.6]). Marked statistical heterogeneity was observed (Q = 1326.84, p < .001, I2 = 95.9%). Subgroup analysis revealed regional variations: Africa exhibited the highest prevalence (21.7%), followed by Asia (14.5%), the Americas (11.8%), and Europe (10.1%). By clinical presentation, pyelonephritis showed the highest pooled prevalence (19.9%), followed by cystitis (12.7%) and asymptomatic bacteriuria (10.4%). Methodological quality appraisal via the Newcastle-Ottawa Scale (NOS) revealed that low-quality studies reported higher estimates (19.2%) than high-quality studies (10.6%). Escherichia coli was the predominant uropathogen, accounting for 60.1% (95% CI [59.3, 60.9]) of isolated strains, followed by Proteus mirabilis (18.3%) and Klebsiella spp. (14.7%).
Conclusion
These findings support routine first-trimester screening for asymptomatic bacteriuria and emphasize adjusting empirical treatment protocols to match regional resistance and strain profiles.
Protocol Registration: PROSPERO (CRD420261411535).
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