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40 Immun., Endoc. & Metab. Agents in Med. Chem., 2014, 14, 40-45
Intake of Vitamin C, Probiotics, Flavonoids and Nutritional Status in
Pregnant Women with Urinary Tract Infection
Paulina Posadas
1
, Rebeca Monroy-Torres
1,
* and Jaime Naves-Sanchez
2
1
Medicine and Nutrition Department of the University of Guanajuato. 20 de Enero 929, Col. Obregón. C.P. 37320.
León, Guanajuato, México;
2
Hospital UMAE-T48 and Maternal and Child Hospital for Ministry of Health in Leon,
Guanajuato, México
Abstract: Urinary Tract Infections are the most common infections seen in medical practice and a frequent complication
in pregnancy. Diet and nutritional status, especially regarding the consumption of certain antioxidants, has a particularly
strong relationship with urinary function and health. The aim of this study was to describe the intake of vitamin C, probi-
otics and flavonoids, and assess the nutritional status of pregnant women with urinary tract infection. A descriptive trans-
versal study was conducted with a pilot sample of 18 pregnant women over 18 years of age, with Urinary Tract Infection,
presenting in any quarter of the pregnancy, and blood counts in their medical records. Body mass index and weight gain
were measured. Intakes of vitamin C, flavonoids and probiotics were analyzed based on the frequency of consumption of
respective food sources. Dietary quality and quantity were analyzed according to report of the frequency of food con-
sumption and in a 24-hour recall (p<0.05). Most patients consumed foods rich in vitamin C. Consumption of flavonoids,
probiotics and water was low. Energy and macronutrient intake was below the recommendations. Nutritional status de-
creased by 50% compared to pre-pregnancy nutritional status, and anemia was present in the 50% of cases. These findings
may lead to defining programs for nutritional and dietary monitoring which could improve the health and nutritional
prognosis for women and newborns, and prevent obstetric complications from Urinary Tract Infection.
Keywords: Antioxidants, nutritional status, pregnant women, probiotics, urinary tract infection, vitamin C.
INTRODUCTION
Urinary tract infections (UTIs) caused by bacteria can
cause significant functional and morphological alterations
[1-3]. The incidence of UTIs varies with age and sex;
women in the age group between 20 and 45 are the most
affected population. Women are more susceptible to UTIs
than men because the female urethra is shorter, which facili-
tates the migration of bacteria into the bladder [4, 5].
UTIs are the most common infectious diseases seen in
medical practice [6, 7] and a frequent complication in preg-
nancy. Their frequency varies between 5 and 10%. The inci-
dence of UTIs is increased in multiparous women, with 5 out
of every 100 pregnant women being affected at the begin-
ning or end of the third trimester of pregnancy [8, 9]. It is
believed that at least 10-20% of women experience an epi-
sode of UTI during their lifetime; an estimated 3% will suf-
fer more than one relapse per year [6].
The condition is often asymptomatic. The detection of
bacteriuria is essential for timely treatment of cystitis and
pyelonephritis in order to prevent complications such as pre-
term labor, premature rupture of membranes, intrauterine
growth retardation and sepsis [1, 8].
Most UTIs are caused by Enterobacteriaceae such as Es-
cherichia coli. Escherichia coli is a gram-negative bacterium
*Address correspondence to this author at the Medicine and Nutrition De-
partment of the University of Guanajuato. 20 de Enero 929, Col. Obregón.
C.P. 37320. León, Guanajuato, México; Tel: 01(477)2674900;
E-mail: rmonroy79@yahoo.com.mx
which is present in 80% of these infections. The presence of
fimbriae in some strains determines their ability to colonize
the urethra and migrate to the bladder [1, 8].
As to pathophysiology, endotoxin stimulates endometrial
contractility via the prostaglandin pathway [9]. Bacterial
infection and endotoxin have destructive effects on the vas-
culature of the uterus and the placenta. The spread of bacte-
ria is promoted by dilation of the urinary tracts, compression
of the bladder by the uterus, hormone-mediated reduction of
ureteral peristalsis, changes in the position of the bladder,
increased renal length, renal filtration, alkalinization of uri-
nary pH and renal leakage of glucose and amino acids. Poor
nutritional status is an additional risk factor and the key point
of interest for this study.
Maternal nutritional status is one of the most important
determinants for a good perinatal outcome [10, 12]. Nutri-
tional assessment includes obtaining anthropometric indica-
tors (pre-pregnancy weight and gestational weight gain) and
analyzing dietary intake in order to measure the approximate
consumption of macronutrients (protein, fat and carbohy-
drates) and micronutrients (vitamins and inorganic nutrients)
[10, 12], in addition to obtaining biochemical and clinical
markers.
A number of normal physiological changes occur during
pregnancy. These could result in complications if appropriate
monitoring and care are not provided. According to de
Benoist et al., 2008, anemia affects 41.8% of pregnant
women globally, with the highest prevalence in Africa [13].
In Mexico, according to the National Health and Nutrition
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