The Effect of Rosa (L. Rosa Canina) on the Incidence of Urinary Tract Infection in the Puerperium: A Randomized Placebo-Controlled Trial

Abstract

Abstract: Introduction: The risk of urinary tract infection (UTI) following cesarean section (CS) increases due to procedures such as catheterization. In-vitro studies have demonstrated the effect of Rosa canina fruit in preventing E.coli growth. This study was conducted to determine the effect of Rosa canina fruit in preventing the incidence of all urinary tract infections (primary outcome) and incidence of the asymptomatic bacteriuria, incidence of cystitis and pyelonephritis (secondary outcomes). Method: This triple-blind randomized clinical trial was conducted in 2016 on 400 women following CS with negative urine culture in Alzahra and Taleghani educational hospitals in the city of Tabriz-Iran. Participants were assigned into two groups of 200 women using block randomization. Each group received a twice daily dose of 500 mg capsules containing Rosa canina or placebo from the second day after CS for 20 days. Women were assessed by U/C on the 7th-10th and 20th days following CS. Data were analyzed using SPSS software (version 19), Chi-square, Linear-by-Linear, Fisher's Exact Test, independent t-test. P value less than 0.05 was considered as significant. Results: Of the 200 participants in each group, in the Rosa canina fruit group, 193 patients completed the study in the first follow-up (7-10 days after surgery) and 184 in the second follow-up (20 days after surgery). In the placebo group, 195 patients completed the study in the first follow-up and 189 in the second follow-up. The most important reason for the loss of samples was the lack of attendance of the participant for follow up. Participants in the research, except in spouse education, did not show significant statistical differences in terms of socio-demographic and chidbirth characteristics. UTI was significantly lower in the intervention group compared to the control in the follow-ups conducted on the 7th-10th days (OR=0.22; Cofidence Interval 95%=0.07 to 0.67; P=0.006) and 20th day (0.32; 0.14 to 0.75; P=0.008). The incidence of asymptomatic bacteriuria in the two groups was statistically significant (P=0.002) but the incidence of cystitis (P= 0.196) and pyelonephritis was not statistically significant between the two groups. Conclusion: Rosa canina fruit capsules were able to reduce the incidence of UTI, especially asymptomatic bacteriuria, after CS. Thus, it is likely that administration of this medication can reduce the risk of urinary tract infections and their complications and promote maternal health following CS.