Currently submitted to: JMIR Research Protocols
Date Submitted: Apr 5, 2026
Open Peer Review Period: Apr 6, 2026 - Jun 1, 2026
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TU(L)IPS Study: Treatment of asymptomatic Urinary tract (Lower) Infection in Pregnancy Screening - Variation in Asymptomatic Bacteriuria Screening in Pregnancy in the UK — Protocol for a National Multicentre Survey and Retrospective Service Evaluation
ABSTRACT
Background:
Asymptomatic bacteriuria (ASB) has been associated with preterm birth and pyelonephritis, and until recently, screening for ASB was recommended for all women in first trimester of pregnancy. Recent divergence between NICE guidelines (which do not recommend routine screening) and NHS initiatives such as the Saving Babies’ Lives Care Bundle (which recommends screening in high-risk women) may have led to inconsistencies in UK clinical practice.
Objective:
To describe the protocol for a national multicentre study evaluating variation in ASB screening practices across UK maternity units and examining associated maternal and neonatal outcomes.
Methods:
The TU(L)IPS study is a national, multicentre observational study conducted through the UK Audit and Research Collaborative in Obstetrics and Gynaecology (UKARCOG) network. The study comprises two components: (1) a structured survey of UK maternity units to characterise local ASB screening guidelines and practices, and (2) a retrospective cohort study using routinely collected clinical data to assess adherence to local and national guidance and to describe maternal and neonatal outcomes. Participating sites contribute data via a standardised REDCap-based data collection platform using predefined variables and harmonised outcome definitions. Analyses will be descriptive, including frequencies and proportions, with comparisons stratified by screening status, urine culture result categories, and preterm birth risk groups.
Results:
The study was launched nationally in January 2025. Recruitment closed with 28 NHS Trusts participating across the United Kingdom. Stage 1 data collection was completed in December 2025. Stage 2 data collection is scheduled to conclude in March 2026, with the database lock planned for March 2026. Data cleaning and analysis will commence following the database lock. The anticipated study completion date is May 2026.
Conclusions:
This study will provide a comprehensive national evaluation of variation in ASB screening practices and associated outcomes in pregnancy. By using a standardised, protocolised approach across multiple sites, the TU(L)IPS study aims to generate contemporary evidence to inform clinical practice and national policy.
Citation
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