Relation between vaginal hygiene practices and spontaneous preterm birth


Researchers from the Netherlands wanted to find out if there is an association between vaginal hygiene practices before and during pregnancy and spontaneous preterm birth. As one of the results, the study suggests that there is a relation between the use of vaginal gel and spontaneous preterm birth. Therefore, a new potential risk factor could have been discovered with this research, and women should be informed about it.

Every year, one in ten babies is born preterm worldwide (born before 37 completed weeks of pregnancy). The number of preterm births is rising and demonstrates a global public health concern, as preterm birth is often accompanied by a range of short and long-term complications.

In Europe, 5.5 to 11.1% of preterm born babies are born spontaneously. Known risk factors are low or high maternal age, low maternal weight or multiple pregnancy. Spontaneous preterm birth is also associated with bacterial vaginosis, which is an imbalanced vaginal flora caused by a disbalance of certain bacteria. Bacterial vaginosis is more often observed in women who practice vaginal douching and can be enhanced by certain detergents. Due to the association between spontaneous preterm birth and bacterial vaginosis, Janssen et al. aimed to find out if and which vaginal hygiene practices might be an additional risk factor for spontaneous preterm birth.

The study was conducted in two university medical centres in Amsterdam, the Netherlands. Vaginal hygiene practices of two groups were compared: 79 women who had a spontaneous preterm birth to 156 women who gave birth at term. Participating women were asked about their vaginal hygiene practices (vaginal washing (water, soap or gel) vaginal douches or vaginal steaming) before and during pregnancy. Also, the frequency of use was documented.

It was found that about 60% of all women washed vaginally with water, before and during pregnancy, 18.3% washed with soap before pregnancy and 15.3% during pregnancy. Vaginal gel was used by 17.0% of all women for vaginal washing before pregnancy and 11.5% during pregnancy. Other practices were less frequently used.

Interestingly, the study showed that women who had spontaneous preterm births used vaginal gel more often than the ones on the control group (term birth). The risk was even higher when the women washed vaginally with gel more than once per week before pregnancy.

Despite the relatively small sample size, the results suggest that vaginal washing with gel during and before pregnancy is a potential risk factor for spontaneous preterm birth. These findings are a starting point for further studies and for health education about hygiene practices during pregnancy.

Paper available at:

Full list of authors: Laura E. Janssen, Rubin J. T. Verduin, Christianne J. M. de Groot, Martijn A. Oudijk, Marjon A. de Boer