Asymptomatic bacteriuria in low-risk pregnancy - what is the evidence of its treatment?

• Autor(a) principal: Cordeiro, Cátia Sofia Leocádio
• Data de Publicação: 2019
• Outros Autores: Ribeiro, Ana Isabel, Cavadas, Luís Filipe
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/1922
• topic: Bacteriuria; Pregnancy; Premature Birth; Primary Health Care; Bacteriuria; Embarazo; Nacimiento Prematuro; Atención Primaria de Salud; Bacteriúria; Gravidez; Nascimento Prematuro; Atenção Primária à Saúde

Asymptomatic bacteriuria (ASB) has been associated with an increased risk of maternal pyelonephritis (PN) and preterm birth (PTB). International clinical guidelines recommend its research and treatment during pregnancy. However, the benefit and risk of screening and treating ASB is not consensual, and this review intends to analyze the available evidence regarding the influence of ASB treatment on maternal and fetal morbidity and mortality. We search on MEDLINE database and Evidence-Based Medicine sites of evidence-based reviews, clinical guidelines, meta-analysis, systematic reviews and randomized controlled trials, using the MeSH terms “Bacteriuria AND Pregnancy”, of articles published between January 2008 and May 2018, in English, French, Spanish and Portuguese. The Strength of Recommendation Taxonomy (SORT) scale of the American Family Physician was used to assess the levels of evidence and assignment of recommendation forces. We identified 136 articles, of which ten met the inclusion criteria. The existing evidence, mostly based on outdated or small and with methodological shortcomings clinical trials, does not allow a clear conclusion as to whether the treatment of ASB positively influences maternal and fetal morbidity and mortality; the most recent data effectively points to a lack of benefit with ASB treatment (SOR B). To address the limitations of the studies found, controlled, randomized, higher quality and larger studies are needed to assess the influence of ASB treatment on maternal and fetal morbidity and mortality.