Can you get a urinary tract infection (UTI) while pregnant? 

 Key takeaways

• Pregnant women are prone to urinary tract infections (UTIs). Hormonal changes during pregnancy can relax the muscles of the urinary tract, making it easier for bacteria to enter and cause an infection.
• Also, the growing uterus can place pressure on the bladder, making it harder for the bladder to completely empty and potentially leading to bacterial growth. 
• UTIs during pregnancy should not be ignored or left untreated, as they can lead to complications such as kidney infections, which can be more serious and potentially harm both the mother and the baby.
• Staying hydrated, practicing good hygiene (including wiping from front to back), urinating before and after sexual intercourse, and wearing breathable underwear are all important steps you should adopt to minimize the risk of UTIs. 

One common issue that can arise during pregnancy is a urinary tract infection (UTI). A UTI occurs when microorganisms—typically bacteria—enter the urethra, causing infection of the urinary tract.

Many pregnant people get urinary tract infections during pregnancy because hormonal and physiological changes occurring during pregnancy can affect the urinary system, increasing the risk of UTIs.

For instance, the growing uterus can exert pressure on the bladder, impairing its ability to completely empty urine. The inability to properly empty the bladder also increases the risk of UTIs. This, along with potential changes in the pH balance of the urinary tract, can increase your risk of developing a UTI during pregnancy.

During your first antenatal visits, your urine will be tested for bacteria. This test is important because your urine may have bacteria even if you don’t have symptoms. By treating a UTI before symptoms appear, you can avoid the possible problems it can cause during pregnancy.

This article answers the question of whether pregnant women can get UTIs during pregnancy, the risk factors involved, signs and symptoms to watch out for, and ways to prevent UTIs to ensure a healthy pregnancy and a healthy baby.

 How UTI is common during pregnancy

Anyone can get a UTI, but it is more common in people assigned female at birth, especially during pregnancy, and can affect both the mother and the developing baby.

According to research, UTI is one of the most common perinatal complications, affecting approximately 8% of pregnancies. This can be due to hormonal and physiological changes that occur during pregnancy.

UTIs during pregnancy should not be ignored or left untreated, as they can potentially lead to complications. If left untreated, a simple UTI can progress to a kidney infection (a more complicated type of UTI), which can be more serious and can potentially harm both the mother and the developing baby. 

Fortunately, UTIs during pregnancy can be effectively treated with antibiotics that are safe for both pregnant women and their babies. Additionally, preventive measures such as staying hydrated, emptying the bladder regularly, and practicing good hygiene can help you reduce the risk of developing a UTI during pregnancy.

Also, it is important that pregnant people see a doctor if they suspect an infection.

 Factors that increase the risk of UTI in pregnancy

Factors that increase the risk of UTI during pregnancy include:

 1. Widening of the ureters

The risk of urinary tract infections (UTIs) increases during pregnancy. Starting around the 6th week of pregnancy, the tubes that carry urine from the kidneys to the bladder (called ureters) begin to get wider.

This is called "hydronephrosis of pregnancy." It reaches its peak at around 22–26 weeks and continues until delivery.

This widening of the ureters can make it easier for infectious microorganisms to enter the urinary tract and cause infection.

 2. Action of the progesterone and estrogen hormones

The hormones progesterone and estrogen, which increase during pregnancy, cause the muscles of the ureters and bladder to relax. This relaxation leads to decreased muscle tone in these areas.

Additionally, an increase in blood volume during pregnancy causes urine to be less concentrated and the bladder to hold more urine.

 3. Backflow of urine from the bladder to the kidneys

Furthermore, there is an increased risk of a condition called vesicoureteral reflux, where urine can flow backwards from the bladder to the kidneys, further increasing the risk of infection.

 4. Increased sugar level in urine

Another factor that can contribute to UTIs during pregnancy is a condition called glycosuria, where there is sugar in the urine. This can also make it easier for bacteria to grow and cause infection.

 5. Urinary stasis

A combination of the above-mentioned changes can cause urine to stay in the urinary tract for longer periods, leading to what is called "urinary stasis." This stagnant urine can increase the risk of bacterial growth and UTIs.

 Symptoms of UTI during pregnancy

UTIs during pregnancy can cause symptoms like:

• Burning sensation or pain with urination (dysuria)
• urinary frequency or urinary urgency 
• Pain on your back or lower abdomen 
• Urine that looks cloudy or has an odor
• Blood in your urine could be red, bright pink, or dark red in color

On the other hand, if you have pyelonephritis (kidney infection) you may experience:

• Fever and chills
• Feeling unwell
• Loss of appetite
• Nausea and vomiting

 UTI complications during pregnancy

Untreated UTI in pregnancy can lead to complications such as:

• Early breakage of the amniotic sac, a water bag that surrounds and protects your baby in the womb during pregnancy
• Infection in the placental tissues and amniotic fluid, a clear, watery fluid that fills your water bag during pregnancy
• Slowed growth of the baby in the womb
• A low-birth-weight baby, i.e., a baby born weighing less than 5.5 pounds (2,500 grams)

 How to treat UTI during pregnancy

Antibiotics are the most common treatment options for pregnant women with UTIs. 

The choice of antibiotics should be safe for both the mother and the baby. Amoxicillin used to be a common choice for treating UTIs in both pregnant and non-pregnant people, but in recent times, it has been found that the bacteria Escherichia coli has become more resistant to this medication.

Cephalosporins and nitrofurantoin, on the other hand, are considered safer antibiotics for treating UTIs in pregnant women. These antibiotic medications have high concentrations in the urine and are effective against Escherichia coli, which is the most common bacteria causing UTIs.

Nitrofurantoin has the advantage of not disrupting the normal bacteria in the vagina, but it should be avoided in the third trimester of pregnancy because it may cause a type of red blood cell breakdown in the baby if the baby has a deficiency in an enzyme called G6PD.

Studies have shown that treating asymptomatic bacteriuria (bacterial infection without symptoms) early in pregnancy can reduce the risk of developing a kidney infection and reduce the chances of having a preterm delivery or a low birth weight baby.

 Tips for preventing UTI during pregnancy

The following tips can help you prevent UTIs:

• Drink plenty of fluids, particularly water.
• Avoid douching.
• Take showers more regularly instead of using bathtubs.
• Always wipe from front to back after using the toilet.
• Urinate before and after sexual intercourse.
• Keep your genital area clean and dry.
• Avoid using harsh soaps or feminine hygiene sprays in the genital area.
• Choose cotton underwear and avoid tight-fitting pants.
• Empty your bladder regularly, and don't hold urine for long.

 When to see a gynecologist for UTI concerns

Consider seeing a gynecologist if you are pregnant and experiencing any of the symptoms of UTI listed in this article.

Also, suppose you have any concerns or complications related to a previous UTI, such as persistent symptoms despite treatment, side effects from antibiotics, or other related issues. In that case, it is advisable to see a gynecologist.