{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:09:35Z","timestamp":1791468575150,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to evaluate the association of bidet toilet use with abnormal vaginal microbial colonization and preterm birth (PTB) in high\u2010risk pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective cohort study of 208 women, who were admitted to a high\u2010risk 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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%, <jats:italic>P<\/jats:italic>\u2009=\u20090.036). Notably, <jats:styled-content style=\"fixed-case\"><jats:italic>Escherichia coli<\/jats:italic><\/jats:styled-content> colonization rate was significantly higher in bidet toilet users than nonusers (13.1% vs 3.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.023). Bidet toilet users had a significantly higher rate of PTB before 37\u2009weeks of gestation, compared to the nonusers (87.3% vs 73.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.040).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that chronic use of a bidet toilet is associated with a higher rate of abnormal vaginal colonization by Gram\u2010negative bacteria and PTB in high\u2010risk pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13953","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T08:54:08Z","timestamp":1552985648000},"page":"1134-1142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prospective study of bidet toilet use: Association of abnormal vaginal colonization and preterm birth in high\u2010risk pregnant women"],"prefix":"10.1111","volume":"45","author":[{"given":"Yoo\u2010Min","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi\u2010Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Asan Medical Center University of Ulsan College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk\u2010Joo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Medical Center Sungkyunkwan University 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