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The effect of genital hygiene behaviors and vaginal douching of pregnant women on preterm labor

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International Journal of Gynecology & Obstetrics
Authors:
Melisa Arikan
Melisa Arikan
Melisa Arikan
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Semra Kocaöz at Niğde Ömer Halisdemir University
Semra Kocaöz
  • Niğde Ömer Halisdemir University
Aynur Kizilirmak
Aynur Kizilirmak
Aynur Kizilirmak
  • This person is not on ResearchGate, or hasn't claimed this research yet.
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Abstract

Objective To determine the effect of genital hygiene behavior (GHB) and vaginal douching (VD) of pregnant women on preterm labor (PTL). Methods This study, which was conducted with 365 pregnant women, is a cross‐sectional study. Data were collected using a questionnaire and the Genital Hygiene Behavior Inventory (GHBI) was applied. Results The ratios of PTL diagnosis and VD practice, and mean GHBI scores of the pregnant women were 35.1%, 9.6%, and 64.42 ± 10.44, respectively. The prevalence of receiving a diagnosis of PTL was significantly higher in those who changed their underwear two to three times a week, took baths while sitting, cleansed their perineum with water using their hands, removed pubic hair at intervals of 2 months or longer, and performed VD. It was found that poor GHB and VD practices increased the rate of PTL and, in particular, VD was found to increase the risk of PTL around eight‐fold. Conclusion These results can help pregnant women to understand the relationship between genital hygiene and PTL and show the importance of being educated by health professionals about this issue.
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1022 
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  Int J Gynecol Obstet. 2024;165:1022–1030.wileyonlinelibrary.com/journal/ijgo
1 | INTRODUCTION
Preterm labor (PTL) is defined as regular uterine contractions that
cause cervical change and cervical dilation of ≥2 cm before 37 weeks
of pregnancy.1 Preterm birth (PTB) occurs in 50% of pregnant
women with PTL.2
Preterm birth is an important public health problem that nega-
tively affects the lives of approximately 15 million babies, mothers,
and families around the world.1 Although frequency varies accord-
ing to income status and geographical regions within countries,
the prevalence of PTB was repor ted to be 11% globally.3 While
more than 60% of PTB cases are seen in Sub- Saharan Africa and
South Asian countries, this value varies by bet ween 5% and 10% in
Europe.4 In studies conducted in Turkey, PTB frequency was found
to be between 17.3% and 38.7% in pregnant women.5,6 During the
medical treatment of PTB, which has a high prevalence, complica-
tions such as HELLP (hemolysis, elevated liver enzymes and low
platelets) syndrome, hypertensive disorders, placental anomalies,
and deterioration of fetal health may develop in pregnant women.1
At the same time, PTB c an cause post- traumatic stress in women be-
cause it threatens the health of the unborn child.7 Apart from its ef-
fects on maternal health, PTB can c ause one million babies to die and
many children to live with disabilities8 or low quality of life.9 PTB also
creates a great economic burden for the health field due to the treat-
ment of premature babies in the intensive care unit, their need for
long- term medical and social care, and economic efficiency losses.8
Received: 30 August 2023 
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 Revised: 15 November 2023 
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 Accepted: 20 November 2023 
|
 Published online: 7 December 2023
DOI: 10.1002/ijgo.15286
CLINICAL ARTICLE
Obstetrics
The effect of genital hygiene behaviors and vaginal douching of
pregnant women on preterm labor
Melisa Arikan1 | Semra Kocaöz2 | Aynur Kizilirmak3
© 2023 Inter national Feder ation of Gynecology and Obstetr ics.
1Mersin City Hospital, Newborn Intensive
Care Unit, Mersin, Turkey
2Zübeyde Hanım Faculty of Health
Sciences, Nursing Department,
Depar tment of Obstet rics an d Gynecology
Nursing, Niğde Ömer Halisdemir
University, Niğde, Turkey
3Semra and Vefa Küçük Faculty of
Health Sciences, Nursing Department,
Depar tment of Obstet rics an d Gynecology
Nursing, Nevşehir Hacı Bektaş Veli
University, Nevşehir, Turkey
Correspondence
Aynur Kizilirmak, Semra and Vefa Küçük
Faculty of Health Sciences, Nursing
Department, Department of Obstetrics
and Gynecology Nursing, Nevşehir Hacı
Bektaş Veli University, Nevşehir, Turkey.
Email: aynur268@gmail.com
Abstract
Objective: To determine the effect of genital hygiene behavior (GHB) and vaginal
douching (VD) of pregnant women on preterm labor (PTL).
Methods: This study, which was conducted with 365 pregnant women, is a cross-
sectional study. Data were collected using a questionnaire and the Genital Hygiene
Behavior Inventor y (GHBI) was applied.
Results: The ratios of PTL diagnosis and VD practice, and mean GHBI scores of the
pregnant women were 35.1%, 9.6%, and 64.42 ± 10.44, respectively. The prevalence
of receiving a diagnosis of PTL was significantly higher in those who changed their
underwear two to three times a week, took baths while sitting, cleansed their perineum
with water using their hands, removed pubic hair at intervals of 2 months or longer,
and performed VD. It was found that poor GHB and VD practices increased the rate
of PTL and, in particular, VD was found to increase the risk of PTL around eight- fold.
Conclusion: These results can help pregnant women to understand the relationship
between genital hygiene and PTL and show the impor tance of being educated by
health professionals about this issue.
KEYWORDS
behavior, hygiene, pregnancy, preterm labor, risk factors, vaginal douching
... For these reasons, the mothers participating in this study emphasized health considerations during pregnancy to improve childbirth preparation. In line with this, various studies have confirmed the impact of improved maternal nutrition [37], increased physical activity [38,39], genital hygiene practices [40], oral hygiene [41,42], and emotional well-being [43] on improving pregnancy and childbirth outcomes. Additionally, mothers mentioned participation in childbirth preparation classes, which have been offered by the Iranian Ministry of Health, and Medical Education since 2008, as a facilitator of childbirth preparation. ...
Childbirth preparation and its facilitating and inhibiting factors from the perspectives of pregnant and postpartum women in Tabriz-Iran: a qualitative study
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Prevalence and predictors of vaginal douching among pregnant women
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Aim This study aimed to determine the prevalence of vaginal douching and its predictors among pregnant women. Methods This cross‐sectional and multi‐center study was conducted from March to November 2024, involving 1523 pregnant women receiving routine antenatal care at four government hospital obstetric outpatient clinics. Data were collected using a structured questionnaire addressing personal and vaginal douching practices. Statistical analyses were performed at a significance level of p < 0.05. Results The prevalence of vaginal douching among the participants was 30.7%. The primary motivation for vaginal douching was personal hygiene, with water being the most frequently used substance. Information about the practice was predominantly obtained from family elders, friends, or individual experience. Misconceptions regarding the hygienic and health implications of vaginal douching were prevalent among participants. Despite awareness of its association with genital infections or related problems, many participants continued the practice. Multiple logistic regression analysis identified significant predictors of vaginal douching, including perceptions that it is hygienic, healthy, and associated with risks of genital infections/problems; a history of genital infections/problems within the previous year; receiving information about vaginal douching from family elders; engaging in sexual intercourse 1–2 times per week during the current pregnancy; being in the third trimester; being unemployed; and having completed secondary or high school education. The independent variables accounted for 73.9% of the variance in the dependent variable ( p < 0.05). Conclusions This study provides essential insights into the prevalence of vaginal douching among pregnant women and highlights their perceptions and motivations for engaging in this practice.
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Article
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Analyzing the Relationship Between Genital Hygiene Behaviors in Women and Urinary Tract Infection in Any Period of Life
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INTRODUCTION: In this study, it is aimed to evaluate the relationship between urinary tract infection [UTI] and genital hygiene behaviors in any period of life. METHODS: The study is single-center and descriptive. All women agreed to participate in the study from the patients admitted to the Health Sciences University Şişli Hamidiye Etfal Research Hospital Family Practice Clinic any reason is planned to be included in the survey. A questionnaire consisting of 36 questions questioning the participants' socio-demographic and genital hygiene behaviors was applied face to face. RESULTS: 142 patients were included in the study. The average age is 38.5 +- 14.2 (min=18, max=70). It was 104 (%73,2) people who had UTI at any time. There was no relation between socio-demographic features and UTI at any time (p≥0.05). In the questioning of Obstetrics and Gynecology information, there was no relationship between the number of pregnancies, the number of births, the most recent birth type, and currently being in menopause and UTI at any time (p≥0.05), but a relationship with the gynecological operation was found (p=0.038). There was a significant correlation between performing genital area cleaning from the back to the front and transmitting UTI in any period (p=0.041). DISCUSSION AND CONCLUSION: As a result, a relationship was found between performing genital area cleaning from the back to the front, having a gynecological operation, and transmitting UTI at any time in life. We think that organizing the right hygiene education and increase the awareness of society will decrease UTI.
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Preterm Labor and Birth: A Clinical Review
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When caring for women experiencing preterm labor and birth, nurses play a significant role as bedside experts, advocates, patient educators, and key members of the maternity care team. Enhanced expertise on clinical and professional knowledge of preterm labor and birth is crucial in prevention and treatment. As preterm birth rates continue to rise, perinatal nurses as well-informed clinical experts have the opportunity to offer innovative education, holistic assessments, and communication through shared decision-making models. Educating pregnant women about early recognition of preterm labor warning signs and symptoms allows for timely diagnosis, interventions, and treatment. Informed and collaborative nursing practice improves quality of clinical care based on individualized interactions. A clinical review of preterm labor and preterm birth is presented for perinatal nurses.
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Global burden of preterm birth
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Preterm birth is a live birth that occurs before 37 completed weeks of pregnancy. Approximately 15 million babies are born preterm annually worldwide, indicating a global preterm birth rate of about 11%. With 1 million children dying due to preterm birth before the age of 5 years, preterm birth is the leading cause of death among children, accounting for 18% of all deaths among children aged under 5 years and as much as 35% of all deaths among newborns (aged <28 days). There are significant variations in preterm birth rates and mortality between countries and within countries. However, the burden of preterm birth is particularly high in low‐ and middle‐income countries, especially those in Southeast Asia and sub‐Saharan Africa. Preterm birth rates are rising in many countries. The issue of preterm birth is of paramount significance for achieving United Nations Sustainable Development Goal 3 target #3.2, which aims to end all preventable deaths of newborns and children aged under 5 years by 2030.
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Bakteriyel Vajinozisin Preterm Eylem Üzerine Etkisi (The Effect of Bacterial Vaginosis on Preterm Labor)
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Her yıl yaklaşık 15 milyon bebek, preterm eylemle doğmakta ve yaklaşık 1 milyon çocuk,preterm eylem sonucu gelişen komplikasyonlar nedeni ile hayatını kaybetmektedir. Pretermeylem gelişiminde rol oynadığı düşünülen çok sayıda risk faktörü bulunmaktadır. Genetikfaktörler değiştirilemez risk faktörleri arasında iken; gebelik yaşı, enfeksiyonlar, çoğul gebelik,stres, beslenme dengesizliği ve sigara içme gibi faktörler değiştirilebilir risk faktörleri arasındayer almaktadır. Değiştirilebilir risk faktörleri arasında yer alan enfeksiyonlardan biri bakteriyelvajinozistir. Bakteriyel vajinozis, kadınlarda sıklıkla görülen ve çoğunlukla asemptomatikseyreden bir durumdur. Bu nedenle, düzenli pelvik muayene yaptırmayan kadınlarda teşhisve tedavisi gecikmektedir. Çok eşli olanlar, sigara içenler, vajinal duş yapanlar ve siyah ırktanolanlar bakteriyel vajinozis açısından risk altındadır. Bakteriyel vajinozis, üreme çağındakikadınlarda sık rastlanan bir enfeksiyon olduğu için gebelik sırasında da görülebilmektedir.Neredeyse her kadının hayatının bir parçasını oluşturan gebelik döneminde, bakteriyelvajinozisin varlığının, preterm eylem görülme riskinde artışa neden olduğu belirlenmiştir. Bunedenle; hemşirelerin, bakteriyel vajinozis açısından riskli gebeleri belirlemede, takip etmede,gerektiğinde tedaviye yönlendirmede, vajinal enfeksiyonlar ve korunma yolları ile ilgili eğitimve danışmanlık vermede preterm eylemlerin önlenmesi açısından önemli rolü vardır.
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Preterm birth (PTB), which occurs in about 12% of pregnancies worldwide, is the main cause of neonatal morbidity and mortality. Symptomatic treatment of pregnancies presenting in preterm labor with corticosteroids and antibiotics has improved neonatal outcomes but has not reduced the incidence of PTB. Evidence suggests that the rate of PTB may be reduced by the prophylactic use of progesterone in women with a previous history of preterm delivery and in those with a short cervical length identified by routine transvaginal ultrasound. This review summarizes the evidence (level A evidence) of the effectiveness of progesterone on the rate of PTB.
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Association of vaginal infections in Preterm labour
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Background: Preterm labour is defined as onset of regular uterine contractions associated with cervical changes between 28-37 completed weeks of gestation. Prematurity is the cause of 85% neonatal morbidity and mortality. Preterm labour has multiple etiologies. Vaginal infections have been associated with increased risk for preterm labour. Screening for genitourinary infections antenatally, especially in high risk cases, prompt recognition and treatment decrease the incidence of preterm labour.Methods: Ours was a prospective and retrospective observational study done at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation from April 2016 to February 2018 in the Department of Obstetrics and Gynaecology. The aim is to study the association of vaginal infections in preterm labour. A total of 116 women in preterm labor were studied. After clinical examination, CBP, CUE, Ultrasound, urine culture and sensitivity were done. Vaginal swab was taken from posterior fornix and sent for culture and sensitivity and gram staining .Culture and sensitivity were done in the Department of Microbiology at our Institute.Results: Out of 116 women in preterm labour, urinary tract infection was seen in 27.58% women. E. Coli was the commonest microorganism isolated in urine (15.51%). Vaginal infections were seen in 33.62% women. Candida was the commonest microorganism isolated in HVS cultures.Conclusions: Screening for genitourinary infections in pregnancy is necessary, especially in high risk cases. Early detection and prompt treatment of genitourinary infections decrease the incidence of preterm labor, thereby decreasing the neonatal morbidity and mortality associated with prematurity.
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The global epidemiology of preterm birth
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This article is part of a series that focuses on the current state of evidence and practice related to preterm birth prevention. We provide an overview of current knowledge (and limitations) on the global epidemiology of preterm birth, particularly around how preterm birth is defined, measured and classified, and what is known regarding its risk factors, causes and outcomes. Despite the reported associations between preterm birth and a wide range of socio-demographic, medical, obstetric, fetal and environmental factors, approximately two-thirds of preterm births occur without an evident risk factor. Efforts to standardize Definitions and compare preterm birth rates internationally have yielded important insights on the epidemiology of preterm birth, and how it could be prevented.
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