Asymptomatic bacteriuria in pregnancy (2018)

Summary of recommendations for clinicians and policy-makers

Recommendations were based on the overall balance between possible benefits and harms of screening, weighing the potential benefits against any harms.

Overall, very low-quality evidence from four cohort studies (n = 7,611) was found for the benefits and harms of screening for asymptomatic bacteriuria in pregnancy. There were few events, effect estimates were highly imprecise, and the Task Force is uncertain about the benefits and harms of screening.

The Canadian Task Force on Preventive Health Care recommends screening pregnant women once during the first trimester with a standard urine culture for asymptomatic bacteriuria (weak recommendation, very low-quality evidence).

This recommendation applies to pregnant women who are not experiencing symptoms of a urinary tract infection and does not apply to women at increased risk of asymptomatic bacteriuria during pregnancy, who should follow guidance for higher-risk populations.

A relatively higher priority was placed on preventing pyelonephritis in the mother, and a relatively lower priority on the possible harms of antibiotic treatment, leading to this recommendation. This recommendation should be applied taking into account clinical circumstances and patient values. This guideline does not apply to women at increased risk of asymptomatic bacteriuria during pregnancy, who should follow guidance for higher-risk populations.