A Multidimensional Risk Factor Analysis of Pediatric Urinary Tract Infections: Bridging Clinical, Behavioral, and Socioeconomic Determinants in an Iranian Pediatric Population

Background: UTI remains a leading bacterial infection with potential for severe long-term morbidity, including renal scarring, hypertension, and CKD. The identification of modifiable risk factors is essential for targeted prevention. This study aimed to comprehensively evaluate factors associated with pediatric UTI in a hospital setting in Sabzevar, Iran.Background: Urinary tract infection (UTI) remains a leading bacterial infection in children, with the potential for severe long-term morbidity, including renal scarring, hypertension, and chronic kidney disease. The identification of modifiable risk factors is essential for targeted prevention. This study aimed to comprehensively evaluate factors associated with pediatric UTI in a hospital setting in Sabzevar, Iran.Methods: This case-control study enrolled ۱۵۰ children under ۱۶ years hospitalized with confirmed UTI and ۱۵۰ age-matched controls hospitalized for non-UTI conditions. Data on demographic, socioeconomic, clinical, and behavioral variables were extracted from medical records and structured parental interviews. Statistical analyses included independent t-tests, Chi-square, and Fisher's exact tests, with significance set at p < ۰.۰۵. Odds ratios (ORs) with ۹۵% confidence intervals (CIs) were calculated from univariate analyses.Results: Among UTI cases, ۱۲۰ (۸۰%) were female and ۳۰ (۲۰%) male (mean age: ۵.۰ ± ۱.۸ years). Significant factors associated with UTI included female sex (p < ۰.۰۰۱), improper perineal hygiene (p < ۰.۰۰۱), uncircumcised status in males (p < ۰.۰۰۱), vesicoureteral reflux (VUR) (p < ۰.۰۰۱), constipation (p = ۰.۰۰۹), neurogenic bladder (p < ۰.۰۰۱), lack of toilet training (p < ۰.۰۰۱), tight underwear use (p < ۰.۰۰۱), bathtub use (p = ۰.۰۰۳), catheterization (p = ۰.۰۰۷), low socioeconomic status (SES) (p < ۰.۰۰۱), rural residence (p < ۰.۰۰۱), growth disorder (p < ۰.۰۰۱), prior UTI history (p < ۰.۰۰۱), family history of kidney stones (p = ۰.۰۰۱), and positive C-reactive protein (p < ۰.۰۰۱). Maternal education (p = ۰.۰۶) and labial adhesion (p = ۱.۰۰) showed no significant association.Conclusion: Beyond established anatomical and physiological factors, socioeconomic status, hygiene practices, and behavioral patterns significantly contribute to pediatric UTI. Early identification and targeted educational interventions addressing these modifiable risks are critical to reducing recurrent infections and long-term renal complications.

کلیدواژه ها:

Children ، Hygiene ، Iran ، Risk factors ، Socioeconomic factors ، Urinary tract infection