Abstract / Summary
Abstract Background Urinary tract infections (UTIs) are among the most prevalent bacterial infections globally and represent a significant public health challenge, particularly in low-resource settings. Women are disproportionately affected due to anatomical predispositions, such as a shorter urethra and proximity to fecal flora. During pregnancy, this susceptibility is further heightened by physiological changes—including hormonal shifts and mechanical compression—that compromise the urinary tract’s natural defense mechanisms. Objective This study aimed to identify the determinants of urinary tract infections among pregnant women attending antenatal care at Gambo General Hospital, Kore District, West Arsi Zone, Oromia Region, Ethiopia, in 2026. Methods A facility-based case-control study was conducted from January to March 2026. A total of 174 participants—58 cases and 116 controls—were recruited. Data were collected using structured questionnaires and medical record reviews, administered digitally via Kobo Toolbox. Bivariate and multivariable logistic regression analyses were performed using SPSS Version 32.0 to identify independent determinants of UTI. Results First trimester (AOR = 4.11; 95% CI: 1.17–14.50), second trimester (AOR = 2.42; 95% CI: 1.02–5.74), grand multigravida status (AOR = 2.87; 95% CI: 1.28–6.44), history of catheterization (AOR = 5.33; 95% CI: 1.38–20.54), low daily water intake <1L (AOR = 4.16; 95% CI: 1.23–14.06), improper genital hygiene (AOR = 4.35; 95% CI: 1.23–15.40), and sexual activity (AOR = 2.57; 95% CI: 1.11–5.92) were significantly associated with UTI. Improper genital hygiene was reported by 82.2% of participants, and inadequate hydration by 45.4%. Conclusion Maternal UTI in this setting is driven by preventable clinical and behavioral gaps rather than physiological inevitability alone, with heightened vulnerability in early gestation. The strong associations with catheterization, hygiene, and hydration highlight a critical need for standardized prenatal counseling and stricter clinical protocols. Ultimately, integrating early screening with community-based education is essential to reducing the infection burden in resource-limited environments.