Prospective study of bidet toilet use: Association of abnormal vaginal colonization and preterm birth in high‐risk pregnant women

Abstract

Aim This study aimed to evaluate the association of bidet toilet use with abnormal vaginal microbial colonization and preterm birth (PTB) in high‐risk pregnancies. Methods This is a prospective cohort study of 208 women, who were admitted to a high‐risk pregnancy unit, due to preterm labor, preterm premature rupture of the membrane, or short cervical length, in two tertiary hospitals from April 2015 to July 2017. Responses to a questionnaire about using bidet toilet and vaginal culture were obtained upon admission. Maternal baseline characteristics, vaginal culture results, and pregnancy and neonatal outcomes were compared between bidet toilet users and nonusers. Results Among the 204 subjects, 67 (32.8%) women were identified as bidet toilet users. Overall, bidet toilet use was associated with a higher rate of abnormal vaginal microbial colonization, compared to the nonusers (60.7% vs 44.2%, P = 0.036). Notably, Escherichia coli colonization rate was significantly higher in bidet toilet users than nonusers (13.1% vs 3.3%, P = 0.023). Bidet toilet users had a significantly higher rate of PTB before 37 weeks of gestation, compared to the nonusers (87.3% vs 73.0%, P = 0.040). Conclusion Our study suggests that chronic use of a bidet toilet is associated with a higher rate of abnormal vaginal colonization by Gram‐negative bacteria and PTB in high‐risk pregnancies.

The Effect of Bidet Use on Severity of Constipation and Quality of Life Among Pregnant Women

“…Beside the effect of bidet toilet use in relieving constipation, studies also report that the use of these toilets in public areas has some risks, and that the water nozzles of bidet toilets are contaminated with a wide range of bacteria, especially in hospitals, making them a potential vehicle for cross-infection. 20,21 Kim et al conducted a study of high-risk pregnant women with preterm labor and reported that the use of a bidet toilet was associated with abnormal vaginal colonization and increased the rate of preterm labor in high-risk pregnancies. 21 Ogino et al conducted a study with 268 non-pregnant women of reproductive age and reported that habitual use of bidet toilets aggravated vaginal microflora, either by depriving normal microflora or facilitating opportunistic infection of fecal bacteria and other microorganisms.…”

“…20,21 Kim et al conducted a study of high-risk pregnant women with preterm labor and reported that the use of a bidet toilet was associated with abnormal vaginal colonization and increased the rate of preterm labor in high-risk pregnancies. 21 Ogino et al conducted a study with 268 non-pregnant women of reproductive age and reported that habitual use of bidet toilets aggravated vaginal microflora, either by depriving normal microflora or facilitating opportunistic infection of fecal bacteria and other microorganisms. 22 Unlike these studies, Asakura et al examined the effect of bidet toilet use on preterm birth and vaginal flora in pregnant women with the participation of 2545 women who gave birth between 2006 and 2010 in Tokyo and reported that normal use of the bidet toilet by pregnant women posed no clinical health risk for preterm birth and bacterial vaginosis.…”

Efficacy and Safety of MED-01 Probiotics on Vaginal Health: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

“…The differences in the changes from baseline to 6 and 12 weeks between the placebo and MED-01 groups were analyzed using a two-sample t -test or Wilcoxon rank sum test. Additionally, an analysis of covariance was conducted with the variables bidet or tampon use and amount of smoking and frequency of intercourse [ 20 , 21 , 22 , 23 , 24 ]. The data are presented as mean ± standard deviation (SD), and the significance of the differences was verified using a two-sided test at p < 0.05.…”

Effect of the Cleanliness of Spray Nozzle on the Concentration of Microorganisms in the Spray Water in Warm-Water Bidet Toilet Seats

“…However, a recent study has shown habitual BTS usage is associated with a high incidence of abnormal vaginal colonization by gram-negative bacteria and preterm birth in high-risk pregnancies (Kim et al, 2019) . Frequent BTS usage was related to anal itching in community-dwelling Japanese people (Tsunoda et al, 2016) .…”