Abstract
BACKGROUND: There has been an increase in infections caused by Escherichia coli during pregnancy. E. coli is a major pathogen posing substantial risks to maternal and fetal health. However, knowledge of the impact of these infections on maternal and fetal outcomes is limited. This study aimed to investigate the high-risk factors related to Escherichia coli infection in pregnant women and associated maternal and fetal outcomes. METHODS: This retrospective analysis was performed using clinical data of pregnant women hospitalized between January 2020 and December 2022 for conditions such as premature rupture of membranes (PROM), threatened preterm labor, threatened miscarriage, and fever, all of whom underwent microbiological testing. Patients were categorized into E. coli or non-E. coli infection groups based on bacterial culture results. High-risk factors for E. coli infection and associated pregnancy outcomes were assessed. RESULTS: Microbiological analysis of 7,213 clinical specimens revealed 925 positive cases, with E. coli infection accounting for 202 cases. Primiparity (odds ratio = 2.981, 95% CI 1.877-4.709, P < 0.001) and a pre-pregnancy body mass index of ≥ 24 kg/m(2) (odds ratio = 1.149, 95% CI 1.062-1.898, P = 0.017) were identified as independent risk factors for E. coli infection. E. coli infection was significantly associated with an increased incidence of preterm PROM. The E. coli infection group exhibited a higher rate of miscarriages before 28 weeks, a lower rate of full-term deliveries, and higher incidences of fetal distress during labor than the non-E. coli infection group. CONCLUSIONS: The prevalence of E. coli is high among pregnant women. This observational study suggests an association between maternal E. coli infection and adverse pregnancy outcomes in high-risk populations.