Pre-pregnancy douching may curb early birth risk

NEW YORK (Reuters Health) - Preliminary results from a study hint that vaginal douching 6 months before pregnancy, but not during pregnancy, may protect African American women from delivering preterm (before 40 weeks).

Although the number of women douching has declined, about half of African American women still douche. In general, douching is more common among minority and low-income women, which may play a role in the disparities of pregnancy outcomes seen in these women.

As douching can promote infection by introducing bacteria into the cervix, uterus or fallopian tubes, Dr. Dawn P. Misra, of the University of Michigan School of Public Health, Ann Arbor, and Britton Trabert of the University of Washington School of Public Health, Seattle speculated that poorer pregnancy outcome would be seen in the women who douched.

They evaluated 832 African-American women living in Baltimore City, Maryland, who received prenatal care at one of four prenatal clinics at Johns Hopkins, or those who delivered at the affiliated hospital after late, intermittent or no prenatal care.

The women were asked if they douched and, if so, at what age did they started and how often they douched before and during pregnancy.

Overall, 533 women (64.1 percent) reported ever douching. A substantial proportion douched 6 months before pregnancy, while only a small number douched during pregnancy.

Overall, 16.4 percent of women delivered preterm.

Vaginal douching fewer than three times per month in the 6 months before pregnancy was associated with a 37 percent reduced risk of preterm delivery compared with women who never douched. Conversely, women who douched during pregnancy had a trend towards increased risk of preterm delivery.

The researchers suggest that symptoms or a diagnosis of infection may have been the reason for douching during the 6-month period before pregnancy, which would account for the apparent productive effect.

"However, because of constraints of our study design and the lack of primary data on infection," they note, "causality cannot be determined or excluded."

SOURCE: American Journal of Obstetrics and Gynecology, February 2007.