Association Between Spontaneous Preterm Labor and Genitourinary Tract Infections Among Pregnant Women in a Tertiary Care Hospital in South India: A Cross-Sectional Study

Introduction and objectives Preterm labor, defined by the WHO as the onset of labor between 20 and 37 weeks of gestation, is a major contributor to neonatal morbidity and mortality, with spontaneous preterm birth accounting for two-thirds of these cases. Genitourinary tract infections, particularly urinary tract infections (UTIs), are a significant risk factor for preterm labor, with studies suggesting that 40% of spontaneous preterm births are associated with genital tract infections. This study aims to determine the association between spontaneous preterm labor and genitourinary tract infections in a sample of antenatal women and evaluate its impact on maternal and neonatal outcomes. Methods This cross-sectional study included 144 antenatal women with spontaneous preterm labor, threatened preterm labor, or preterm premature rupture of membranes (PPROM), presenting between 28 and 37 weeks of gestation at Sri Ramachandra Medical College. Midstream urine samples and vaginal swabs were collected for culture and sensitivity testing. Additional parameters, such as maternal age, body mass index (BMI), parity, socioeconomic status (SES), and history of preterm births, were recorded. Blood tests were performed to measure total counts and C-reactive protein (CRP) levels. Maternal and neonatal outcomes, including birth weight and neonatal sepsis, were analyzed. Results Of the 144 women, 34 (24%) had a positive UTI culture, with <i>Escherichia coli</i> being the most common organism isolated (35%). The majority of UTI-positive cases were observed in women aged 25-29 years (13, 38%) and those from lower socioeconomic classes (22, 65%). A significant association was found between positive UTI cases and elevated total white blood cell counts and CRP levels. Neonatal outcomes in UTI-positive cases included low birth weight (13, 38%) and neonatal sepsis (3, 9%), while maternal complications were mostly limited to asymptomatic bacteriuria and acute cystitis. Conclusion The study demonstrates a significant association between spontaneous preterm labor and UTIs. Regular screening for genitourinary infections in pregnancy, particularly in high-risk groups such as women from lower socioeconomic backgrounds, could help reduce the incidence of preterm labor and improve neonatal outcomes. Early diagnosis and treatment of UTIs are crucial for preventing complications in both mothers and neonates.