Causes and Treatments of a UTI During Pregnancy
Medically reviewed on May 19, 2023 by Karen Janson, MS, MD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- Causes of a UTI During Pregnancy
- Symptoms of UTI During Pregnancy
- Can a UTI Harm My Baby?
- Diagnosing a UTI During Pregnancyxxx
- Treating a UTI During Pregnancy
- What If I Have Recurring UTIs During Pregnancy?
- How Can I Prevent a UTI During Pregnancy?
- Related Content
Pregnancy is an incredible phase of life where a host of anatomical and hormonal transformations take place. Some of these changes in a pregnant woman can heighten the risk of developing certain health issues, including an infection of the urinary tract (UTI). [1]
A urinary tract infection is treatable when addressed promptly, but may be difficult to catch early if it has no observable UTI symptoms.
If you’re pregnant, it’s important to understand the factors that contribute to developing a UTI and how to address them if they arise. This comprehensive guide to UTIs during pregnancy will cover everything you need to know to protect both your and your baby’s well-being.
Causes of a UTI During Pregnancy
It’s a well-known fact that pregnant people tend to experience changes in their bathroom habits (namely with regard to frequency), but UTIs during pregnancy aren’t as commonly discussed.
Two main changes contribute to the increased likelihood of developing a UTI in pregnancy: [1]
- Changes in hormones and anatomy – Progesterone, one of the main hormones in circulation during pregnancy, has muscle-relaxing properties. [1] High levels of progesterone have been shown to cause the ureters to expand, contributing to the retention of urine. [1] This may make someone who is pregnant more vulnerable to infection. In addition, the enlarging fetus and uterus can compress the bladder and ureters, impeding the normal flow of urine and increasing the opportunity for infection.
- Changes in the immune system – Pregnant people undergo changes in their immune system to prevent the body from rejecting their baby. [3] This usually results in a state of immunocompromise, where the immune system may be less reactive to the pathogens it encounters. [1] For this reason, pregnant individuals may be more susceptible to developing infections, like UTIs.
Evidence suggests that the biggest risk factor for developing a UTI during pregnancy is the increased possibility of asymptomatic bacteriuria (ASB). [1] This refers to the presence of bacteria in the urine that presents no symptoms of a UTI. [5]
Approximately 1 in 4 people who are pregnant with asymptomatic bacteriuria will develop a UTI. [1] To prevent the infection from progressing, it’s recommended a urine sample is tested for ASB at your first prenatal appointment. [1]
Additional Risk Factors for Developing a UTI
Being pregnant is considered a risk factor for UTIs because of the anatomical and hormonal changes that occur during pregnancy. Certain preexisting health conditions may make you even more susceptible to a UTI, including: [8]
- Having diabetes – Living with diabetes can impact both your urological physiology and your ability to sense when you need to empty the bladder. [7] These changes may increase the likelihood of urine retention, elevating a person’s risk of infection. [7]
- Having Sickle Cell trait or disease – has been associated with an increased risk for UTIs.[1,2]
- Having an immune disorder – Depressed immune function may make it more difficult for your body to fight off infection, making you more susceptible to a UTI.
Finally, individuals who have a structural abnormality of the urinary tract or injury to the nerves supplying the bladder or spinal cord may experience urine retention, contributing to the risk of developing a UTI. [9]
Symptoms of UTI During Pregnancy
The common symptoms associated with UTIs depend on the type of UTI you develop. Healthcare providers recognize three main types of UTIs that occur in both pregnant and non-pregnant people: [2]
- Asymptomatic UTIs, an infection that does not exhibit any noticeable symptoms
- Cystitis, an infection of the bladder and lower urinary tract
- Pyelonephritis, an infection of the kidneys and upper urinary tract
It’s estimated up to 7% of pregnant people may carry an asymptomatic UTI. An untreated asymptomatic infection has a 25% chance of developing into cystitis or pyelonephritis. [2] If you do observe UTI symptoms, you may notice:
- Feeling the need to urinate even after going to the bathroom (frequency)
- Feeling an urgent need to urinate (urgency)
- Feeling pain or burning sensation while urinating
- Urine that appears cloudy (pyuria) or discolored with blood (hematuria)
- Urine that carries an odor
- Pain or pressure around your pelvis, flanks, or lower back
More complicated UTIs may be accompanied by fever, chills, nausea, or vomiting.
Recognizing any of these symptoms is a signal it’s time to reach out to your healthcare provider. UTIs—including pyelonephritis—are common, highly treatable, and rarely result in serious maternal or fetal health risks. [4] Nevertheless, it’s important to address them early to prevent the infection from spreading and minimize any potential adverse pregnancy health effects.
See related: Can a UTI Go Away on its Own?
Can a UTI Harm My Baby?
Pyelonephritis is the most severe form of a UTI, and may develop in pregnant people who don’t recognize or treat their UTI early. [1] Most cases of pyelonephritis are treatable, even in pregnancy. However, in rare cases, it can cause serious health complications for mother and child, including: [1,2]
- Fluid in the lungs
- Sepsis
- Pre-term labor
- Low-birthweight [5]
If you are pregnant and observe symptoms of a UTI, reach out to your healthcare provider as soon as possible. [1]
Diagnosing a UTI During Pregnancy
Going through any health scares during pregnancy can feel frightening, but UTIs are relatively easy to diagnose and treat.
To diagnose a UTI, healthcare providers will collect a urine sample to screen for abnormalities. In more complicated cases, they may also request the following labs: [1]
- Complete blood count
- Electrolyte evaluation
- Creatine evaluation
In addition, your healthcare provider will perform some tests, like monitoring fetal heart rate, to ensure your baby’s vital signs are healthy. [1]
Treating a UTI During Pregnancy
If you have a UTI, your healthcare provider will likely prescribe a round of antibiotics to treat the infection. In non-pregnant people, both single-day and multi-day courses of antibiotics may be used to treat a UTI.1 However, for pregnant people, a 3 to 7 day course is usually preferred.1, 2 A repeat urine evaluation 2-4 weeks after treatment may also be recommended to assure there is no signs of re-infection. [1]
Antibiotics used to treat UTIs in pregnancy include: [1]
- Amoxicillin, Amoxicillin-Clavulanate
- Cephalosporins
- Fosfomycin
- Nitrofurantoin, depending on the stage of pregnancy
- Trimethoprim-sulfamethoxazole, depending on the stage in pregnancy
What If I Have Recurring UTIs During Pregnancy?
Do you ask yourself ‘Why do I keep getting a UTI?’ People who have had a UTI before have a higher likelihood of developing another one, and the same principle applies to pregnant people. Around 50% of people assigned female at birth who develop a UTI will have another one within the same year. [7]
If you experience recurring UTIs during pregnancy, your healthcare provider may suggest a low, daily course of antibiotics for you to take. This is referred to as suppressive antibiotic therapy. [2] Suppressive therapy works by helping to keep instances of infection at bay while your body is immunocompromised. [2]
How Can I Prevent a UTI During Pregnancy?
Several techniques can help reduce your risk of exposure to bacteria that can cause a UTI. Tips on how to prevent UTI include: [2]
- Drinking plenty of fluids, especially water
- Emptying the bladder at least every 3-4 hours while awake
- Going to the bathroom before and after you have sex
- Wiping from front to back after using the bathroom
- Opting for cotton underwear
- Wearing loose-fitting clothing
Get a Headstart on Your Health with Everlywell
Being pregnant gives new meaning to the idea that taking care of your health is a way of taking care of others. Fortunately, UTIs seldom pose a health risk to either you or your future baby as long as they are diagnosed and treated early.
If you’re looking for ways to stay ahead of your urinary and reproductive health, check out Everlywell’s telehealth services. We can connect you with a licensed clinician who will discuss your symptoms and concerns with you, at your convenience. If needed, your provider may recommend online UTI treatment to help improve your symptoms.
Everlywell makes it easy to know your health status earlier, with a built-in support system of provider referrals to help you get the treatment you need.
For more ways to get ahead of your and your growing family’s well-being, check out our virtual care services today.
Related Content
Can a UTI Be Transmitted Through Sex?
References
- Habak PJ, Griggs RP. Urinary Tract Infection In Pregnancy - NCBI bookshelf. July 5, 2022. URL.Accessed May 11, 2023.
- Horsager-Boehrer R. Utis during pregnancy are common and treatable: Your pregnancy matters: UT southwestern medical center. Your Pregnancy Matters | UT Southwestern Medical Center. URL.September 20, 2021. Accessed May 11, 2023.
- News Center. Immune system changes during pregnancy are precisely timed. News Center. URL.September 1, 2017. Accessed May 11, 2023.
- Urinary tract infection (UTI). Mayo Clinic. URL.September 14, 2022. Accessed May 11, 2023.
- Givler DN, Givler A. Asymptomatic bacteriuria - statpearls - NCBI bookshelf. URL.February 19, 2023. Accessed May 11, 2023.
- What antibiotics are safe during pregnancy? Mayo Clinic. URL.August 25, 2022. Accessed May 11, 2023.
- Diabetes and its impact on your urinary and sexual health. Urology Care Foundation. URL.Accessed May 11, 2023.
- Johnson CY, Rocheleau CM, Howley MM, Chiu SK, Arnold KE, Ailes EC. Characteristics of women with urinary tract infection in pregnancy. Journal of women’s health (2002). URL.November 2021. Accessed May 11, 2023.
- Definition & Facts of kidney infection (pyelonephritis) - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. URL.Accessed May 11, 2023.