Predictors of urinary tract infection at the first prenatal visit

We identified maternal demographic, behavioral, and medical history factors that predict bacteriuria (that is, symptomatic and asymptomatic urinary tr act infection) at prenatal care initiation. We applied logistic regression modeling to data from all prenatal care recipients who delivered during 199 0-1993 and resided in selected North Carolina counties (N = 8037), omitting those with diabetes mellitus, human immunodeficiency virus, or structural urologic abnormalities. The two strongest predictors of bacteriuria at pren atal care initiation were an antepartum urinary tract infection prior to pr enatal care initiation (for whites, adjusted prevalence odds ratio (POR) = 2.5, 95% CI 0.6-9.8; for blacks, POR = 8.8, 95% CI 3.8-20.3) and a pre-preg nancy history of urinary tract infection (POR = 2.1, 95% CI 1.4-3.2). For w hite women only, education beyond high school and age greater than or equal to 30 years were inversely associated (POR less than or equal to 0.6). Sic kle cell hemoglobin nearly doubled the prevalence odds for bacteriuria amon g African-Americans (POR = 1.9, 95% CI 1.0-3.5), whereas African-Americans with normal hemoglobin had reduced prevalence odds compared with whites (PO R = 0.6, 95% CI 0.4-0.9). This study suggests predictors not considered bef ore, including race controlling for sickle cell disease or trait and antepa rtum urinary tract infections prior to prenatal care.