Sandra McAteer, Paige Wartko, Anjum Hajat, Sharon Fuller, Susan M Shortreed, Anne Butler, Daniel A Enquobahrie, Robin Garcia, Sascha Dublin
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We used modified poisson regression to estimate the cumulative incidence and adjusted risk ratios ([aRR]; with non-Hispanic [NH] White individuals as a reference) of the first UTI per pregnancy, adjusted for maternal age. <b><i>Results:</i></b> Among 63,029 pregnancies across eight racial and ethnic categories, 5,083 (8.1%) individuals experienced UTI during pregnancy. Cohort mean maternal age was 30.4 years and 75.9% of birth outcomes were live or stillbirths. UTI risk ranged from 7.2% among NH White individuals to 14.3% among NH Native Hawaiian/Pacific Islander [NHPI] individuals. Compared to NH White individuals, UTI risk was elevated among NH NHPI (aRR 1.80, 95% confidence interval [CI] 1.50-2.15), NH Black (aRR 1.32, 95% CI 1.19-1.46), NH Asian (aRR 1.13, 95% CI 1.04-1.24), and Hispanic (aRR 1.45, 95% CI 1.32-1.59) individuals. We observed no differences in UTI treatment by race or ethnicity. <b><i>Conclusion:</i></b> UTI burden during pregnancy is greater among racially minoritized groups, suggesting a need for more focus on upstream risk factors, screening, and alleviating the influence of structural racism on infection risk.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Racial and Ethnic Disparities in the Incidence and Treatment of Urinary Tract Infection During Pregnancy.\",\"authors\":\"Sandra McAteer, Paige Wartko, Anjum Hajat, Sharon Fuller, Susan M Shortreed, Anne Butler, Daniel A Enquobahrie, Robin Garcia, Sascha Dublin\",\"doi\":\"10.1089/jwh.2024.0940\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Urinary tract infections (UTIs) occur in 10-18% of United States pregnancies and may lead to maternal and neonatal complications. We examined differences in the incidence and treatment of UTI during pregnancy by race and ethnicity. <b><i>Methods:</i></b> We conducted a cohort study within an integrated health care system, including members aged 15-49 years with live births, stillbirths, spontaneous abortions, or terminations between January 2011 and August 2023. Self-reported race and ethnicity were documented in the electronic health record (EHR). UTIs were defined from diagnosis, medication, and laboratory data. We used modified poisson regression to estimate the cumulative incidence and adjusted risk ratios ([aRR]; with non-Hispanic [NH] White individuals as a reference) of the first UTI per pregnancy, adjusted for maternal age. <b><i>Results:</i></b> Among 63,029 pregnancies across eight racial and ethnic categories, 5,083 (8.1%) individuals experienced UTI during pregnancy. Cohort mean maternal age was 30.4 years and 75.9% of birth outcomes were live or stillbirths. UTI risk ranged from 7.2% among NH White individuals to 14.3% among NH Native Hawaiian/Pacific Islander [NHPI] individuals. Compared to NH White individuals, UTI risk was elevated among NH NHPI (aRR 1.80, 95% confidence interval [CI] 1.50-2.15), NH Black (aRR 1.32, 95% CI 1.19-1.46), NH Asian (aRR 1.13, 95% CI 1.04-1.24), and Hispanic (aRR 1.45, 95% CI 1.32-1.59) individuals. 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引用次数: 0
摘要
背景:尿路感染(uti)发生在10-18%的美国妊娠,并可能导致产妇和新生儿并发症。我们研究了不同种族和民族在妊娠期尿路感染发生率和治疗方面的差异。方法:我们在一个综合医疗保健系统中进行了一项队列研究,包括2011年1月至2023年8月期间15-49岁的活产、死产、自然流产或终止妊娠的成员。自我报告的种族和民族记录在电子健康记录(EHR)中。尿路感染是根据诊断、用药和实验室数据来定义的。我们使用修正泊松回归来估计累积发病率和校正风险比([aRR];以非西班牙裔[NH]白人个体为参照),根据产妇年龄进行调整。结果:在8个种族和族裔类别的63029例怀孕中,5083例(8.1%)在怀孕期间经历了尿路感染。队列平均产妇年龄为30.4岁,75.9%的分娩结果为活产或死产。尿路感染的风险范围从NH白人个体的7.2%到NH夏威夷原住民/太平洋岛民[NHPI]个体的14.3%。与NH白人个体相比,NH NHPI个体(aRR 1.80, 95%可信区间[CI] 1.50-2.15)、NH黑人个体(aRR 1.32, 95% CI 1.19-1.46)、NH亚洲个体(aRR 1.13, 95% CI 1.04-1.24)和西班牙裔个体(aRR 1.45, 95% CI 1.32-1.59)的UTI风险升高。我们观察到尿路感染治疗没有种族或民族差异。结论:少数种族群体妊娠期尿路感染负担更重,需要更多关注上游危险因素,筛查和减轻结构性种族主义对感染风险的影响。
Racial and Ethnic Disparities in the Incidence and Treatment of Urinary Tract Infection During Pregnancy.
Background: Urinary tract infections (UTIs) occur in 10-18% of United States pregnancies and may lead to maternal and neonatal complications. We examined differences in the incidence and treatment of UTI during pregnancy by race and ethnicity. Methods: We conducted a cohort study within an integrated health care system, including members aged 15-49 years with live births, stillbirths, spontaneous abortions, or terminations between January 2011 and August 2023. Self-reported race and ethnicity were documented in the electronic health record (EHR). UTIs were defined from diagnosis, medication, and laboratory data. We used modified poisson regression to estimate the cumulative incidence and adjusted risk ratios ([aRR]; with non-Hispanic [NH] White individuals as a reference) of the first UTI per pregnancy, adjusted for maternal age. Results: Among 63,029 pregnancies across eight racial and ethnic categories, 5,083 (8.1%) individuals experienced UTI during pregnancy. Cohort mean maternal age was 30.4 years and 75.9% of birth outcomes were live or stillbirths. UTI risk ranged from 7.2% among NH White individuals to 14.3% among NH Native Hawaiian/Pacific Islander [NHPI] individuals. Compared to NH White individuals, UTI risk was elevated among NH NHPI (aRR 1.80, 95% confidence interval [CI] 1.50-2.15), NH Black (aRR 1.32, 95% CI 1.19-1.46), NH Asian (aRR 1.13, 95% CI 1.04-1.24), and Hispanic (aRR 1.45, 95% CI 1.32-1.59) individuals. We observed no differences in UTI treatment by race or ethnicity. Conclusion: UTI burden during pregnancy is greater among racially minoritized groups, suggesting a need for more focus on upstream risk factors, screening, and alleviating the influence of structural racism on infection risk.
期刊介绍:
Journal of Women''s Health is the primary source of information for meeting the challenges of providing optimal health care for women throughout their lifespan. The Journal delivers cutting-edge advancements in diagnostic procedures, therapeutic protocols for the management of diseases, and innovative research in gender-based biology that impacts patient care and treatment.
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