Risk of Urinary Tracy Infection Among Pregnant Women with Anemia: A Systematic Review and Meta-Analysis

Muhammad Farhan Wibowo; Rifaldy Nabiel Erisadana; Leo Prawirodiharjo; Willy Akbar

doi:10.24198/obgynia.v8i3.853

Risk of Urinary Tracy Infection Among Pregnant Women with Anemia: A Systematic Review and Meta-Analysis

Muhammad Farhan Wibowo, Rifaldy Nabiel Erisadana, Leo Prawirodiharjo, Willy Akbar

Abstract

Objective: This study aims to provide an evidence-based answer to whether anemia during pregnancy is a risk factor for the development of UTI

Methods: A literature search for the systematic review and meta-analysis was carried out by PubMed, ScienceDirect, and Scopus databases for observational studies that reported the incidence of anemia during pregnancy and urinary tract infections (UTI). Quantitative analysis of pooled odd ratio with a 95% confidence interval was performed using Review Manager 5.4 software and visualized by forest plot graph

Result: Based on 9 articles included in the analysis, anemia revealed a statistically significant for UTI [Pooled OR 2.38, 95% CI: 1.24—4.56; p<0.00001] but not for asymptomatic bacteriuria (ASB) [Pooled OR 2.08, 95% CI: 0.89—4.90; p=0.09]. We accumulated both outcomes for the total bacteriuria and demonstrated statistically significant [Pooled OR 2.27, 95% CI: 1.38—3.75; p<0.0001].

Discussion: Statistical significance was observed for the development of UTI 2.38 times in pregnant women with anemia compared to pregnant women without anemia.

Conclusion: This research showed evidence that anemia during pregnancy was a significant risk factor for the development of UTI and bacteriuria, but not a significant risk factor for ASB.

Risiko Infeksi Saluran Kemih pada Ibu Hamil dengan Anemia: Tinjauan Sistematis dan Meta-Analisis

Abstrak

Tujuan: Penelitian ini bertujuan untuk memberikan jawaban berbasis bukti mengenai apakah anemia selama kehamilan merupakan faktor risiko untuk perkembangan ISK atau bukan

Metode: Metode yang digunakan dalam penelitian ini adalah tinjauan sistematis dan meta-analisis yang disusun berdasarkan PRISMA guideline. Pencarian literatur dilakukan melalui basis data PubMed, ScienceDirect, dan Scopus pada penelitian observasional yang melaporkan kejadian anemia selama kehamilan dan infeksi saluran kemih (ISK). Analisis kuantitatif untuk gabungan odd ratio dengan interval kepercayaan 95% dilakukan menggunakan perangkat lunak Review Manager 5.4 dan divisualisasikan dengan grafik forest plot

Hasil: Berdasarkan 9 artikel yang disertakan dalam analisis menunjukkan bahwa anemia selama kehamilan memiliki hubungan yang signifikan terhadap kejadian ISK [Pooled OR 2.38, 95% CI: 1.24—4.56; p<0.00001], tetapi tidak untuk bakteriuria asimtomatik (ASB) [Pooled OR 2,08, 95% CI: 0,89—4,90; p=0,09]. Kami menggabungkan kedua hasil untuk total bakteriuria dan menunjukkan signifikansi statistik [Pooled OR 2,27, 95% CI: 1,38—3,75; p<0,0001].

Pembahasan: Anemia selama kehamilan dapat meningkatkan risiko ISK sebesar 2,38 kali lebih tinggi daripada tanpa anemia yang terjadi melalui mekanisme disregulasi sistem imun. Pemantauan kadar hemoglobin pada periode antenatal dapat menjadi upaya skrining faktor risiko terjadinya ISK.

Kesimpulan: Anemia selama kehamilan merupakan faktor risiko untuk perkembangan ISK dan bakteriuria, tetapi bukan faktor risiko untuk ASB. Evaluasi faktor risiko dan penatalaksanaan anemia lebih dini menjadi upaya penting bagi klinisi dalam mencegah perkembangan terjadinya ISK selama kehamilan

Kata kunci: Anemia; faktor risiko; infeksi saluran kemih; kehamilan; meta-analisis

Keywords

Anemia, bacteriuria, meta-analysis, pregnancy, urinary tract infections

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DOI: http://dx.doi.org/10.24198/obgynia.v8i3.853