title: Are unhygienic practices during the menstrual, partum and postpartum periods risk factors for secondary infertility?
abstract: This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighbourhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery' at an unclean place (adjusted odds ratio [AOR]=1.7, 95% confidence interval [CI] 1.1-2.6), delivery by a birth attendant without washing hands with soap (AOR=4.2, 95% CI 2.36-7.47), use of unclean material for absorption of lochia (AOR=3.1, 95% CI 1.5-6.5), non-washing of perineal area after urination/defaecation (AOR=7.1, 95% CI 1.4-35.7), and insertion of home-made vaginal medications (AOR=2.5, 95% CI 1.3-4.7). Since these factors are preventable/modifiable to a great extent, public-health interventions are, thus, recommended to address these risk factors at various levels.
authors.affiliation: Department of Community Health Sciences, School of Nursing, Aga Khan University, Karachi, Pakistan.
authors.forename: Tazeen Saeed
authors.initials: TS
authors.lastname: Ali
authors.forename: Neelofar
authors.initials: N
authors.lastname: Sami
authors.forename: Ali Khan
authors.initials: AK
authors.lastname: Khuwaja
mesh_terms: D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006920:Hygiene; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology*; D008597:Menstrual Cycle; D016017:Odds Ratio; D010154:Pakistan / Q000453:epidemiology; D049590:Postpartum Period; D012307:Risk Factors