Guidance and practice --early pregnancy urine cultures

Asymptomatic bacteriuria (ASB) complicates 2-10% of pregnancies, and has been linked with an increased risk of pyelonephritis and preterm birth. In 2021, UK national guidelines recommended against routine early pregnancy ASB screening. We undertook an analysis of pseudonymised data from the early Life Cross Linkage in Research-Born-in-South London (eLIXIR-BiSL) clinical data linkage platform, to examine the nature of current practice. From data available from 01 October 2018 to 11 July 2023, there were 78,166 antenatal care bookings, of which 36,952 (47.3%) were associated with a mid-stream urine culture for ASB screening. There was no appareant impact of the August 2021 change to national guidance, with non-adherence before and after this time. These data highlight the need to measure (de-)implementation of clinical practice recommendations.