Me-Linh Luong1, Michael Libman1, Mourad Dahhou2, Moy Fong Chen3, Susan R Kahn4, Lise Goulet5, Louise Séguin5, John Lydon6, Helen McNamara7, Robert W Platt8, Michael S Kramer8. 1. Department of Microbiology and Immunology, McGill University, Montreal QC. 2. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal QC. 3. Department of Pathology, McGill University, Montreal QC. 4. Department of Medicine, McGill University, Montreal QC. 5. Département de médecine sociale et préventive, Université de Montréal, Montréal (Quebec). 6. Department of Psychology, McGill University, Montreal QC. 7. Department of Obstetrics and Gynecology, McGill University, Montreal QC. 8. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal QC; Department of Pediatrics, McGill University, Montreal QC.
Abstract
OBJECTIVE: Vaginal douching and bacterial vaginosis (BV) are independently associated with spontaneous preterm birth. Because the interrelationships among these variables remain unclear, we sought to examine the associations in a prospective study. METHODS: We conducted a nested case-control study within a prospectively recruited cohort of pregnant women. We prospectively collected demographic and health status data, data on pre-pregnancy vaginal douching, vaginal smears for bacterial vaginosis as defined by Nugent's criteria, fetal fibronectin at 26 weeks of pregnancy, and placental pathology at delivery. Spontaneous preterm births before 37 weeks' gestation were selected as cases. All spontaneous births occurring after 37 weeks were potential control subjects. To limit costs, some tests were performed only in selected control subjects. RESULTS: Preterm birth occurred in 207 of 5092 women (4.1%). In bivariate analysis, BV was not associated with preterm birth (OR 1.2; 95% CI 0.5 to 2.4). Vaginal douching was significantly associated with bacterial vaginosis (P < 0.05) and preterm birth (P < 0.05). On multivariate analysis, vaginal douching was no longer associated with preterm birth, but a significant association with early preterm birth < 34 weeks (OR, 6.9; 95% CI 1.7 to 28.2) and preterm birth due to preterm labour (OR 3.0; 95% CI 1.1 to 8.5) persisted after controlling for the presence of bacterial vaginosis and placental inflammation. CONCLUSION: Vaginal douching and bacterial vaginosis were not associated with spontaneous preterm birth overall. However, vaginal douching appears to be an independent and potentially modifiable risk factor for early preterm birth (32-34 weeks), although the mechanism remains unclear.
OBJECTIVE: Vaginal douching and bacterial vaginosis (BV) are independently associated with spontaneous preterm birth. Because the interrelationships among these variables remain unclear, we sought to examine the associations in a prospective study. METHODS: We conducted a nested case-control study within a prospectively recruited cohort of pregnant women. We prospectively collected demographic and health status data, data on pre-pregnancy vaginal douching, vaginal smears for bacterial vaginosis as defined by Nugent's criteria, fetal fibronectin at 26 weeks of pregnancy, and placental pathology at delivery. Spontaneous preterm births before 37 weeks' gestation were selected as cases. All spontaneous births occurring after 37 weeks were potential control subjects. To limit costs, some tests were performed only in selected control subjects. RESULTS:Preterm birth occurred in 207 of 5092 women (4.1%). In bivariate analysis, BV was not associated with preterm birth (OR 1.2; 95% CI 0.5 to 2.4). Vaginal douching was significantly associated with bacterial vaginosis (P < 0.05) and preterm birth (P < 0.05). On multivariate analysis, vaginal douching was no longer associated with preterm birth, but a significant association with early preterm birth < 34 weeks (OR, 6.9; 95% CI 1.7 to 28.2) and preterm birth due to preterm labour (OR 3.0; 95% CI 1.1 to 8.5) persisted after controlling for the presence of bacterial vaginosis and placental inflammation. CONCLUSION: Vaginal douching and bacterial vaginosis were not associated with spontaneous preterm birth overall. However, vaginal douching appears to be an independent and potentially modifiable risk factor for early preterm birth (32-34 weeks), although the mechanism remains unclear.
Authors: M Carter; M Gallo; C Anderson; M C Snead; J Wiener; A Bailey; E Costenbader; J Legardy-Williams; T Hylton-Kong Journal: West Indian Med J Date: 2013-01 Impact factor: 0.171
Authors: R J Diclemente; A M Young; J L Painter; G M Wingood; E Rose; J M Sales Journal: J Pediatr Adolesc Gynecol Date: 2011-11-03 Impact factor: 1.814
Authors: Christine Tagliaferri Rael; Doyel Das; Jose Bauermeister; Cody Lentz; Alex Carballo-Diéguez; Rebecca Giguere; Rachel K Scott; Craig W Hendrix Journal: AIDS Behav Date: 2021-05-12
Authors: Luz-Jeannette Sierra; Amy G Brown; Guillermo O Barilá; Lauren Anton; Carrie E Barnum; Snehal S Shetye; Louis J Soslowsky; Michal A Elovitz Journal: PLoS One Date: 2018-01-18 Impact factor: 3.240