Laboratory Diagnostic Findings of Urinary Tract Infections among Pregnant Women at Xai-Xai Provincial Hospital, Mozambique: A Retrospective Record Review (2019–2020)

Abstract

Introduction: Urinary tract infections (UTIs) are among the most prevalent bacterial complications during pregnancy, affecting approximately 25% of pregnant women. In Sub-Saharan Africa, prevalence may reach 32.12%, increasing the risk of maternal morbidity and adverse neonatal outcomes, such as low birth weight and prematurity. Physiological, hormonal, and anatomical changes inherent to pregnancy heighten susceptibility to these conditions, necessitating accurate diagnostic strategies adapted to local realities. Aims: This study aimed to assess the frequency of use and to characterize distribution of diagnostic method and the microbiological profile among pregnant women attending the Xai-Xai Provincial Hospital, Mozambique. Methodology: A retrospective study with a quantitative approach was conducted, analyzing laboratory records and the WXDISA electronic database of HPXX from 2019 to 2020. The final sample consisted of 42 pregnant women with a confirmed UTI diagnosis. Variables analyzed included sociodemographic data, diagnostic methods (microscopy, dipstick testing, and culture test), and bacterial etiology. Data were processed using SPSS version 25, applying descriptive statistics. Results: The analysis revealed increasing vulnerability throughout pregnancy, with 59.5% of cases occurring in the third trimester. The most affected age group was 18 to 21 years (33.3%).The microscopy showed the highest detection frequency (73.8%) surpassing culture test (26.2%) in routine practice, with leukocyturia of intensity 3+ (47.6%) as the predominant inflammatory marker in urinary sediment. The microbiological profile was led by Escherichia coli (50.0%), followed by Klebsiella spp. (19.0%) and Candida albicans (19.0%). Most patients (69.0%) were managed on an outpatient basis. Conclusions: The findings highlight the increased vulnerability of pregnant women in the third trimester and the frequent use of urine sediment microscopy as a screening tool in routine practice.  The predominance of E. coli aligns with global patterns; however, the significant presence of other pathogens suggests the need to update treatment protocols for the Gaza province. This study provides local scientific evidence that may inform public health policies and epidemiological surveillance in prenatal care.