Risk factors for urinary tract infection in the postpartum period

OBJECTIVE: We sought to examine risk factors for urinary tract infection in postpartum women. STUDY DESIGN: Subjects (n = 931) with maternal urinary tract infections and control subjects (n = 1862) were identified by using a linked Washington S tate birth certificate and Birth Events Records Database for the years 1987 -1993; stratified analysis was performed by using Mantel-Haenszel procedure s. RESULTS: Increased risk for postpartum urinary tract infection was associat ed with black, Native American, or Hispanic race-ethnicity (odds ratio, 1.3 0; 95% confidence interval, 1.03-1.64) and unmarried status (odds ratio, 1. 33; 95% confidence interval, 1.11-1.58). Cesarean delivery (odds ratio, 2.7 0; 95% confidence interval, 2.27-3.20) and tocolysis (odds ratio, 3.30; 95% confidence interval, 2.15-5.06) also contributed to maternal risk of acqui ring a urinary tract infection. Maternal risk factors included renal diseas e (adjusted odds ratio, 3.89; 95% confidence interval, 1.80-8.41) and preec lampsia-eclampsia (adjusted odds ratio, 3.21;95% confidence interval, 2.36- 4.38). Among women undergoing vaginal delivery renal disease (odds ratio, 5 .47; 95% confidence interval, 2.04-14.64) and abruptio placentae (odds rati o, 5.02; 95% confidence interval, 1.84-13.64) were risk factors. Length of hospital stay was significantly associated with urinary tract infection. CONCLUSION: Maternal medical conditions and procedures that predispose to u rinary tract infections are those that also are associated with urethral ca theterization. In addition, maternal urinary tract infections may contribut e significantly to duration of postpartum hospital stay.