Assessment of Pregnant Woman's Awareness Regarding Urinary Tract Infection in Babylon Maternity Teaching Hospital
*Suad Abdul Hussein
1, Huda abdal ruda
1, Amal kareem Abdul rahman
1, Deyar Basem
1, Walaa Hussein Allawi
1, Noor Muhamad Atyee
11 Nursing Department, Hilla university college, Babylon, Iraq.
*Correspondingauthor:[email protected]
Abstract
Back ground: The most common bacterial infection during pregnancy is urinary tract infection its may be symptomatic and estimated that20 % of women will experience this infection in their lifetime, and the probability of infection is 30 time than men
Objectives: The mainobjectives of the study was determined the assessment of pregnant women's awareness regarding the urinary tract infection .
MethodologyA descriptive study was conductedin Babyl Maternity Hospital in Hilla City during the period December 20th 2020-Febreary20th 2021. The sample of the study included (purposive) sample (100) pregnant women with urinary tract infection the data were collected through the use of interview questionnaire and checklist.
Results: The study show the range of study sample was from(20-25) years(71%) and more than half of them with low education level , the urban residences were predominated its (76%) and most of them were employ (77%) with enough monthly income and in related to obstetric history the result reflect (40%) of sample they were having one abortion they were visited the antenatal care center one time and (62%) of them were in the second trimester of pregnancy, mostly of them without medical history,the studysample were having poor awareness regarding urinary tract infection because of low of education level according toIraqi educational sheet (Unicef, 2020). Conclusion: The overall awareness at low level of score , therefore the study recommending suggested that the prenatal care services should be readjusted about the risks of UTduring pregnancy.
Keywords-urinary tract infection. Pregnant woman.
Introduction
Urinary tract infection(UTI)are common in pregnancy and may be asymptomatic, its estimated that 20%of women will develop urinary tract infection during their lifetime (ACOG,2008) . Most cases of UTIs are caused by bacteria especially gastrointestinal bacteria which infects the urethra
through contaminate the area around the rectum and spread to the to the bladder(Anulis 2016) Previous studies have showen that women with more than three children have urinary tract infections
(okonko et al ,2009).Urinary tract infection may be the result of misdiagnosis, and is regarding as the common hospital acquire infection(Koffuor 2012 –Kolawole 2009)
During pregnancy, the tendency of UTI increases partly due to the pressured of the gravid uterus on the ureters causing stasis of urine flow and is also attributed to the hormonal and immunological changes during normal pregnancy (WHO,2005 and Zeighmih, 2008) , Urinary incontinence occurs during pregnancy due to enlarged pelvis and kidneys,increased urine output and changes in the position of the bladder in pelvis to abdomen ,reduction in vesicles muscle tone and relaxation in the bladder and ureter smooth muscle tissues caused by impregnation with progesterone ,glycosuria and amino aciduria (Manual2005 –Hiilberg 2003) there for, pregnant women should have routine urine test in
low urine concentration and increased blood volume (Delzell.,2000). Pregnancy increases the risk of UTI at around 6th weeks of gestational age due to the physiological change of the ureters begin to dilate this is also known as hydronephrosis of pregnancy which peaks at 22-26 weeks and continue to persist until delivery (Delze2000)
The prevalence of UTI among pregnancy during the second trimester accounted up in 50% and has defined as consequences of lack of treatment during pregnancy(Koffuor 2012)Women with untreated urinary tract infection during third trimester of pregnancy are at risk with mental retardation or development delay(McDemott et al .,2001)the child which born
Objectives of study. To assess women awareness regarding to UTI
And to find out the relationship between UTI and some variable related to age, education level, resident, gravida ,para abortion and past medical history
MATERIAL AND METHODS
Adescriptivedesign performed at Babylon maternity hospital conducted on a purposive sample of ( 100) pregnant women who have UTI during the period December 20th 2020-Febreary20th 2021.
The data have been collected via the questionnaire which consists demographic and reproductive data.
The datahave been analyzed by using the statisticpackage for social sciences version( 20 ) descriptive
and inferential statisticsweredescriptive and inferential statistics have beenused.
RESULTS AND DISCUSSION
Table-1:Descriptive Statistic Analysis of Demographic Variables
Variables Rating N=100 %
Age/years
>20 years old 3 3.0
20-25 years old 71 71.0
26-30 years old 9 9.0
31and older 17 17.0
Level of education
illiterate 5 5.0
Read and write 59 59.0
Primary school 8 8.0
Secondary school 18 18.0
Institute and above 10 10.0
Residence Urban 76 76.0
Rural 24 24.0
Occupation Employ 77 77.0
Unemployed 23 23.0
Income
Enough 51 51.0
Partially enough 25 25.0
Not enough 24 24.0
N=Number, %= Percentage
The results reflect descriptive statistics of socio-demographic characteristics in terms of frequencies and percentages. Out of (100) subjects participated in our study aged range from (20-25) years of age and constituted (71 percent) of the study sample. Education-related results indicate that women read and write were more than half of study findings and represented that (59 percent) out total number. In terms of residence, the urban residences were predominated, it constituted (76 percent). Most of women were employ with enough monthly income, it composed (77 and 51 percent) respectively.
Table 2:Descriptive Statistic Analysis of Obstetric History
Variables Rating N=100 %
Number of Gravida
No 9 9.0
1 53 53.0
2 28 28.0
3 10 10.0
Number of Para
No 16 16.0
1 52 52.0
2 26 26.0
3 6 6.0
Number of abortion
No 28 28.0
1 40 40.0
2 14 14.0
3 18 18.0
Visit antenatal care during this pregnancy
One 42 42.0
Two 19 19.0
Three 39 39.0
Trimester you are now
1st 29 29.0
2nd 62 62.0
3rd 9 9.0
N=Number, %= Percentage
Findings depicts that (53% & 52%) were one Gravida and Para, forty percent of them were with one abortion, and (62%) visit antenatal care in second trimester of pregnancy.
Table -3:Descriptive Statistic Analysis of Medical History
Variables Rating N=100 %
Previous Urinary Tract Infection Yes 53 53.0
No 47 47.0
History of gestational diabetic you or one of your family
Yes 16 16.0
No 84 84.0
History of Urinary tract stones Yes 6 6.0
No 94 94.0
History of genital urinary tract anomalies Yes 3 3.0
No 97 97.0
History of Anemia during pregnancy Yes 49 49.0
No 51 51.0
History of cystocele or rectocele Yes 3 3.0
No 97 97.0
History of using contraceptive Yes 43 43.0
No 57 57.0
N=Number, %= Percentage
The results reflect (53%) were have previous UTI , (97%) and the remaining mostly not have history of problems.
Table -4: Pregnant women awareness regarding UTI
List Awareness items Rating N=100 % S.d. M.s. Ass.
1 Washing perineum from front to back and dry it after each urination and defecation
Never 60 60.0
0.857 1.65 Poor
Sometime 15 15.0
Always 25 25.0
2 Immediately go to pass urine if you feel
Never 76 76.0
0.722 1.38 Poor
Sometime 10 10.0
Always 14 14.0
Always 16 16.0 4 Always eating healthy food
Never 63 63.0
0.892 1.65 Poor
Sometime 9 9.0
Always 28 28.0
5 Take some herbalist for UTI
Never 79 79.0
0.747 1.37 Poor
Sometime 5 5.0
Always 16 16.0
6 Take some medication to treat the UTI
Never 61 61.0
0.869 1.65 Poor
Sometime 13 13.0
Always 26 26.0
7 Take more coffee daily
Never 63 63.0
0.892 1.65 Poor
Sometime 9 9.0
Always 28 28.0
8 Use plenty of detergent to clean perineum daily
Never 58 58.0
0.957 1.79 Moderate
Sometime 5 5.0
Always 37 37.0
9 Take urine for bacterial test
Never 58 58.0
0.882 1.70 Moderate
Sometime 14 14.0
Always 28 28.0
"N= Number, %= Percentage, M.s.= Mean of score, Cut off point (0.66), poor (mean of score 1-1.66), moderate (mean of score 1.67-2.33), good (mean of score ≥2.34), S.d= Stander deviation"
Take in to account cut-off point, this table illustrates the pregnant women responses were poor awareness towards UTI infection (M.s.=1-1.66) except, the pregnant were moderate aware plenty of detergent to clean perineum daily and take urine for bacterial test (M.s.=1.67-2.33).
Table -5: Overall awareness regarding Urinary Tract Infection
Overall Knowledge
Rating N=100 % S.d. M.s. Ass.
Poor awareness 52 52.0
0.594 1.53 Poor awareness Moderate awareness 43 43.0
Good awareness 5 5.0
Total 100 100.0
"N= Number, %= Percentage, M.s.= Mean of score, Cut off point (0.66), poor (mean of score 1-1.66), moderate (mean of score 1.67-2.33), good (mean of score ≥2.34), S.d= Stander deviation"
Overall, according to the analysis mean of score, the findings indicate that the majority (52%) of pregnant women were poor awareness at low level score mean +S.d.= 1.53+0.594.
Figure -1: Overall Awareness Assessment 0
10 20 30 40 50 60
Poor (M.s.=1-1.66) Moderate (M.s.=1.67- 2.33)
Good (M.s.≥2.34)
%
Knowledge
Table -6:Chi-square analysis Relationship between Pregnant knowledge and their Demographic Characteristics
Variables Rating Awareness
Total d.f Sig.
Poor Moderate Good
Age
>20 years old 2 1 0 3
6
Chi − square= 5.121 P-value=0.528 NS
20-25 years old 40 28 3 71
26-30 years old 3 6 0 9
31and older 7 8 2 17
Total 52 43 5 100
Education
Unable to read 2 3 0 5
8
Chi − square= 26.673 P-value=0.001
S
Read and write 35 22 2 59
Primary school 6 2 0 8
Secondary school 4 14 0 18
Institute and ≥ 5 2 3 10
Total 52 43 5 100
Residency
Urban 39 34 3 76
2
Chi − square =0.952 P-value=0.621 NS
Rural 13 9 2 24
Total 52 43 5 100
Occupation
Employ 47 29 1 77
2
Chi − square = 16.651 P-value=0.000
HS
Unemployed 5 14 4 23
Total 52 43 5 100
Monthly income
Enough 33 15 3 51
4
Chi − square =8.036 P-value=0.090 NS
Partially enough 9 15 1 25
Not enough 10 13 1 24
Total 52 43 5 100
"𝛘𝟐= Chi-square, Df= Degree of freedom, P-value= Probability value, S= significant, NS= non significant, S= significant, HS= high significant"
This table indicate that pregnant women age, residences and monthly income have been no significant associated with their awareness at p-value>0.05. as well as, the pregnant their education and occupation have been associated with their awareness at p-value ≤0.05
Table -7: Mean differences (ANOVA) between the Overall Awareness and their Obstetric History
Variables d.f Mean Square F Sig.
Number of Gravida
Between Groups 2 2.271
3.848 0.025
Within Groups 97 0.590 NS
Total 99
Number of Para
Between Groups 2 1.201
1.982 0.143
Within Groups 97 0.606 NS
Total 99
Number of abortion
Between Groups 2 0.261
0.233 0.793
Within Groups 97 1.120 NS
Total 99
Visit antenatal care during this pregnancy
Between Groups 2 8.661
13.211 0.000 HS
Within Groups 97 0.656
Total 99
Trimester you are now
Between Groups 2 0.121
0.347 0.708
Within Groups 97 0.348 NS
Total 99
By ANOVA test, findings shows that there is no statistical significant between obstetric history and pregnant awareness at p-value >0.05 except, the number of antenatal visit were highly influenced with pregnant awareness at p-value <0.01.
Table -8: Mean differences (ANOVA) between the Overall Awareness and their Medical History
Variables d.f Mean Square F Sig.
Previous Urinary Tract Infection
Between Groups 2 2.408
11.626 0.000
Within Groups 97 0.207 HS
Total 99
History of gestational diabetic you or one of your family
Between Groups 2 0.069
0.500 0.608
Within Groups 97 0.137 NS
Total 99
History of Urinary tract stones
Between Groups 2 0.020
0.353 0.704
Within Groups 97 0.058 NS
Total 99
History of genital urinary tract anomalies
Between Groups 2 0.042
1.425 0.245
Within Groups 97 0.029 NS
Total 99
History of Anemia during pregnancy
Between Groups 2 8.488
102.725 0.000 HS
Within Groups 97 0.083
Total 99
History of cystocele or rectocele
Between Groups 2 0.011
0.374 0.689 NS
Within Groups 97 0.030
Total 99
History of using contraceptive
Between Groups 2 0.673
2.816 0.065 NS
Within Groups 97 0.239
Total 99
By ANOVA test, findings shows that there is no statistical significant between medical history and pregnant awareness at p-value >0.05 except, the previous urinary tract infection and history of anemia during pregnancy were highly affected pregnant awareness at p-value <0.01.
Table (1) shows that the high percentage of pregnant women within age(20-25) years (71%), education result indicate that women read more than half of study findings and represented that (59 percent) of the total number. .In terms of residence, the urban residences were predominated, it constituted (76 percent) According to Iraq education fact sheets 2020 ,two third of child not attending early childhood education (67%) and (68%) live in urban area. Most women have sufficient monthly income, it composed (77 and 51 percent) respectively. The result showthat the maternal education statues and occupation had been significantly association with developing the UTI.This result is similar to study done in ALsadder City 2016 byAli Sh,at el .This is may be due to the same societies(Mohammed, 2020).
Table (2) shows that the high percentage for pregnant women that (53% & 52%) were one Gravida and Para, forty percent of them were with one abortion, and (62%) visit prenatal services in second trimester of pregnancy, and findings shows that there is no statistical significant between obstetric history and pregnant awareness at p-value >0.05 except, the number of antenatal care visit were highly influenced with pregnant awareness at p-value <0.01. This finding is similar kind of study were carried to investigate the prevalence of UTI and the associated risk factors among pregnant women the first antenatal visit by Sescon et al.2003.
Table (3) this table illustrates the pregnant women responses were poor awareness towards UTI infection (M.s.=1-1.66) except, the pregnant were moderate aware plenty of detergent to clean perineum daily and take urine for bacterial test (M.s.=1.67-2.33).and there is no statistical significant between medical history and pregnant awareness at p-value >0.05 except, the previous urinary tract infection and history of anemia during pregnancy were highly affected pregnant awareness at p-value <0.01.Study done by Emiru et al 2013 and Haider et al found the significant of risk factors like anemia, low income level ,past history of UTI and sexual activity in causing UTI among women during pregnancy was been explored and validated by several research, Overall, according to the analysis mean of score, the findings show that the majority (52%) of pregnant women has poor awareness at low level score mean +S.d.= 1.53+0.594. So the study recommended that the prenatal care services should be readjusted aiming to enable more program for explanation about the risks of UTI during pregnancy.
CONCLUSION
The overall awareness at low level of score , therefore the study recommending suggested that the prenatal care services should be readjusted about the risks of UT during pregnancy.
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