Analysis of Microbial Colonization, Including Multidrug-Resistant Gram-Negative Bacteria, in High-Risk Pregnant Women

Introduction: Preterm birth (PTB) remains a global challenge in obstetrics and is a leading cause of neonatal morbidity. It is estimated that at least 40% of all PTB are due to intrauterine infections. Given the concerning trend of multidrug resistance and limited resources, especially in gram-negative bacteria, early detection of colonization and risk factors is essential to prevent adverse outcomes. In this study, we analyzed the associations between maternal microbial colonization in pregnancy, particularly considering the prevalence of multidrug-resistant gram-negative (MRGN) and its impact on prenatal pregnancy-related complications. Methods: This retrospective, single-center cohort study consisted of 596 high-risk pregnant women, who were admitted to the hospital between February 2016 and April 2018. Based on their pregnancy complications, which led to admission, three subgroups were considered: non-infection-related (Non-Infected), infection-related (Infected), and Cervical-Insufficient. A total of 1319 swab samples collected from skin, perianal area, and vagina were screened on culture media and were categorized as nonpathogenic, MRGN, pathogenic gram-negative, pathogenic gram-positive bacteria, and unicellular organisms, for example, yeast. Statistical analyses included chi-square test. p -Values