Abstract
Background
Maternal urinary tract infections (UTIs) remains the commonest non-intestinal infection globally, and it is a major public health concern. Moreover, Vitamin D is a known immunomodulator, and its deficiency is common in pregnant women. Few evidence shows vitamin D deficiency may expose the urinary tract to infections. For the first time, this study investigated the prevalence, associated factors and effect of Vitamin D probiotics fortification on asymptomatic UTIs among pregnant women in Ghana.
Methods
This prospective cohort study included 126 pregnant women aged 18 years and above without symptoms of UTI attending antenatal care at the Ejisu Government Hospital and Juaben Government Hospital in Ejisu-Juaben Municipality in the Ashanti Region, Ghana. Pregnant women were further divided into Vitamin D probiotics fortified group (63) and non-fortified group (63) and follow-up for 6 months. Sociodemographic and clinical data were collected. Venous blood samples were also collected at baseline and end line for laboratory analyses. Quantification of serum 25(OH)D levels was done using ELISA (Thermo scientific). Statistical analyses were done in SPSS version 26.0 and GraphPad version 8.0 at p < 0.05 and 95% confidence interval.
Results
This study found 23.6% prevalence of UTI among pregnant women with most isolated bacteria being Escherichia coli (69.0%) and staphylococcus spp. (17.2%). In a logistics regression prediction model, inadequate knowledge on UTI (cOR: 2.85, 95% CI: (1.00-8.14); p = 0.049) was significantly associated with 3-odds increased likelihood of UTI, and poor attitude towards UTI (aOR: 3.00, 95% CI: (1.22–7.37); p = 0.017) was independent predictor of increased chances of UTI among pregnant women. At end line of treatment, the prevalence of UTI among Vitamin D fortified group reduced from 21.0–3.2% and among non-fortified group reduced from 26.2% 16.4%, indicating a drastic effects of Vitamin D fortification in reducing UTI among pregnant women.
Conclusion
The prevalence of UTI remains high among pregnant women. Inadequate knowledge on UTI and poor attitude towards UTI contributes significantly to increasing chances of UTI among pregnant women. However, public health strategies incorporating Vitamin D supplementation could reduce UTI incidences and related adverse maternal and neonatal outcomes.