title: The patterns and criteria of vaginal douching and the risk of preterm labor among upper Egypt women.
abstract: OBJECTIVE
  Our study identifies vaginal douching as a risk factor for preterm labor and specifies the risk according to the method, frequency, nature, and timing of douching.
  
  
  METHODS
  This is a hospital-based case-control study. A total of 480 women were recruited. Women were classified into case group (history of preterm labor) and control group (no history of preterm labor). An interview questionnaire was administered, which included participants' data and criteria of douching practice.
  
  
  RESULTS
  Among participants who regularly douched (73.13%), 281 (80.06%) used it for cleanliness and religious considerations. Women who have been regularly douched were at higher risk of preterm labor (adjusted odds ratio [OR] = 1.9; 95% CI = 1.078-3.278; p = .026). The method (fingers vs pump) and the frequency of douching were significantly relevant. The risk of douching during pregnancy was borderline (adjusted OR = 2.1; 95% CI = 1.001-4.446; p =.05). Douching several times per day has an OR of 4.05 (95% CI = 1.196-13.737; p =.025) when compared with the monthly frequency.
  
  
  CONCLUSIONS
  Vaginal douching is associated with higher risk of preterm labor. We recommend that the risk of asymptomatic bacterial vaginosis should be considered.
authors.affiliation: Woman's Health Center, Assiut University, Assiut, Egypt.
authors.forename: Mostafa Mohammed
authors.initials: MM
authors.lastname: Khodary
authors.forename: Sherif Abd-Elkarim Mohammed
authors.initials: SA
authors.lastname: Shazly
authors.forename: Mohamed Khairy
authors.initials: MK
authors.lastname: Ali
authors.forename: Ahmed Yahia Abdel
authors.initials: AY
authors.lastname: Badee
authors.forename: Omar Mamdouh
authors.initials: OM
authors.lastname: Shaaban