The Difference Between UTI and Pregnancy Symptoms

The difference between urinary tract infection (UTI) and pregnancy symptoms include a strong urge to pee and cloudy or smelly urine. A UTI may also cause similar symptoms to pregnancy, such as a frequent urge to pee. A UTI happens when bacteria enter the urinary tract, which includes the bladder, kidneys, ureters, and urethra.

UTIs are not uncommon during pregnancy. A study published in 2022 found that 18% of 43,846 women reported having a UTI during pregnancy.

A UTI happens when bacteria enter and colonize the urinary tract. A UTI can affect any part of the urinary tract, which includes the bladder, kidneys, ureters, and urethra. UTIs most commonly occur in the bladder.

The bacterium Escherichia coli (E. coli) causes up to 90% of UTIs. These bacteria are found in the intestines and near the anus, where they typically don’t cause trouble. Bacteria can create a colony in the urinary tract, resulting in a UTI, if they get into the urethra. 

The culprit behind UTIs during pregnancy is the same, but they differ slightly from others. Hormonal changes may make the body more vulnerable to bacteria. Pregnancy increases levels of the hormone progesterone.

Hormonal changes during pregnancy may cause changes to the urinary tract, such as:

• Reducing bladder capacity, which causes a frequent urge to urinate
• Relaxing the sphincters near the base of the bladder and urethra, enlarging the urethra opening and allowing bacteria to enter
• Causing urine to flow backward toward the ureters or kidneys

Pregnancy can also weaken the immune system. White blood cells, which typically fight germs that cause illnesses, may not be as efficient at fending off bacteria.

Many pregnant people may have bacteria that cause UTIs without realizing it. A study published in 2019 found that up to 15% of all pregnancies involve asymptomatic bacteriuria. The bacteria behind these infections are present but don’t cause symptoms. 

Pregnant people may have similar UTI symptoms as non-pregnant people, such as:

• Burning feeling when you pee
• Feeling tired
• Fever
• Foul-smelling urine
• Frequent urge to pee
• Pain in your back, below your ribs, or sides
• Painful urination
• Pressure in your lower abdomen
• Shakiness
• Urine that appears cloudy or red

Some of these symptoms can be similar to pregnancy symptoms, such as a frequent urge to pee and feeling tired. You can tell the difference between UTI and pregnancy symptoms if you have a strong urge to pee and cloudy or smelly urine.

A UTI during pregnancy generally doesn’t affect the fetus if the infection involves the bladder. An infection can spread to the kidneys if it’s left untreated. A kidney infection can be dangerous for the pregnant person and the fetus. You may have more severe symptoms, such as bloody urine, chills, and nausea, if a UTI becomes more severe and reaches your kidneys.

Kidney infections are more common during pregnancy since UTIs may not cause symptoms. That’s why the U.S. Preventive Services Task Force advises pregnant people to take a urine test at their first prenatal visit or between the first 12 to 16 weeks of pregnancy.

An untreated UTI during pregnancy may lead to other complications like:

• Low birth weight (i.e., less than 5.5 pounds)
• Preeclampsia, or high blood pressure during pregnancy
• Premature birth (i.e., before 39–40 weeks)

A short course of antibiotics is usually enough to resolve a UTI in the bladder. Certain drugs might not be safe for the fetus. Research has found that pregnant people who use specific drugs to treat a UTI before or during their first trimester have an increased risk for congenital disabilities.

These drugs include:

• Ciprofloxacin
• Nitrofurantoin
• Trimethoprim-sulfamethoxazole

A healthcare provider can advise you on what antibiotics are safe for you at any point during your pregnancy. The good news is that five- or six-day courses of antibiotics are typically helpful. Short courses of antibiotics are unlikely to cause harm to the fetus.

Treatment is more involved if a UTI reaches the kidneys. You’ll likely need to spend a few days in the hospital and receive antibiotics and intravenous (IV) fluids. You may need IV antibiotic therapy if group B Streptococcus, which is a group of bacteria, is found in your urine culture.

It’s worth taking steps to avoid getting a UTI, between the difficulty of treating one during pregnancy and the unpleasant symptoms. Try some of the following to prevent a UTI during pregnancy:

• Aim to drink six to eight glasses of fluids daily.
• Avoid douching or using feminine hygiene sprays.
• Change out of sweaty or wet clothes right away.
• Don’t wear tight-fitting pants that trap moisture.
• Make sure you clean your anal and vulvar regions daily.
• Take showers instead of baths, or only bathe for less than 30 minutes.
• Urinate at least once every three to four hours. Bacteria are more likely to grow if urine stays in your bladder for long periods.
• Urinate before and after sexual activity.
• Wear cotton underwear.
• Wipe front to back to avoid spreading bacteria from the anal region to the urethra.

More research is needed to know if cranberry supplements prevent UTIs. Some evidence suggests they may help. Cranberry supplements might be safe to use during pregnancy, but results have been mixed. It’s important to talk to a healthcare provider or pharmacist before starting cranberry supplements.

Consult a healthcare provider if you have UTI symptoms, especially kidney infection symptoms. These symptoms include:

• Chills or night sweats
• Confusion
• Fatigue
• Fever higher than 101 degrees
• Nausea or vomiting
• Severe abdominal pain
• Shaking
• Side, back, or groin pain
• Skin that’s flushed, red, or warm

A healthcare provider will test your urine during early pregnancy and later on since UTIs during pregnancy often don’t cause symptoms. These tests include a urinalysis and urine culture. A urinalysis tests your urine for white blood cells, which may indicate an infection. A urine culture tests your urine for bacteria that cause UTIs.