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Asymptomatic bacteriuria in pregnancy is a risk factor for pyelonephritis, which in turn raises risk for maternal and neonatal morbidity; accordingly, in 2008 the USPSTF recommended routine screening of pregnant women for asymptomatic bacteriuria at 12 to 16 weeks' gestation or during the first prenatal visit if it occurs after that time. These updated recommendations reflect the growing recognition that antimicrobial resistance and perturbation of the microbiome are consequences of treating asymptomatic bacteriuria, while likelihood of pyelonephritis is low in pregnant women with asymptomatic bacteriuria who do not receive treatment.