Document Type : Original Article


Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Urinary tract infection is a common infection in women during pregnancy, leading to
many complications for both mother and fetus if untreated. The present study aimed to investigate the
predictability of constructs of the theory of planned behavior (TPB) in adopting urinary tract infection
prevention behaviors in pregnant women.
MATERIALS AND METHODS: In the present cross‑sectional study, we selected 100 pregnant
women who visited the comprehensive health service centers of Zarrinshahr using convenience
sampling from July to September 2019. We collected data by a questionnaire designed based on
the constructs of the TPB and analyzed data using SPSS 20 and linear regression test and Pearson
correlation coefficient. A significant level was considered as α < 0.05.
RESULTS: In the study, the Pearson correlation coefficient showed direct relationships between the
score of behavior and the scores of knowledge (P = 0.005), attitude (P = 0.02), perceived behavioral
control (P < 0.001), and behavioral intention (P = 0.001). Linear regression analysis indicated that
among the above variables, the perceived behavioral control, knowledge, and behavioral intention
were significant predictors of scores of urinary tract infection prevention behaviors, respectively, in
terms of their importance.
CONCLUSION: In this study, perceived behavioral control is detected as the main predictor of
doing urinary tract infection prevention behaviors in pregnant women and should be considered in
designing educational interventions.


1. Singh B, Tilak R, Srivastava R K, Katiyar K. Urinary tract infection
and its risk factors in women: an appraisal. J Pure Appl Microbiol
2. Turay A A, Eke S O, Oleghe PO, Ozekhome M C. The prevalence
of urinary tract infections among pregnant women attending
antenatal clinic at Ujoelen primary health care centre, Ekpoma,
Edo state, Nigeria. IJBA IR 2014;3:86‑94.
3. Flores‑Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary
tract infections: Epidemiology, mechanisms of infection and
treatment options. Nat Rev Microbiol 2015;13:269‑84.
4. Abou Heidar  NF, Degheili  JA, Yacoubian  AA, Khauli  RB.
Management of urinary tract infection in women: A  practical
approach for everyday practice. Urol Ann 2019;11:339‑46.
5. Oladeinde  BH, Omoregie  R, Oladeinde  OB. Asymptomatic
urinary tract infection among pregnant women receiving
ante‑natal care in a traditional birth home in Benin city, Nigeria.
Ethiop J Health Sci 2015;25:3‑8.
6. Jido  TA. Urinary tract infections in pregnancy: Evaluation of
diagnostic framework. Saudi J Kidney Dis Transpl 2014;25:85‑90.
7. Abd El Aziz MS, Ibrahim HA, Elgzar WT. Effect of application of
health belief model on pregnant women’ knowledge and health
beliefs regarding urogenital infections. JNHS 2016;5:34‑44.
8. Gufareen H, Nishat Z, Aftab Afroze M, Ambreen H. Risk factors
of urinary tract infection in pregnancy. JPMA JPak Med Assoc
9. Szweda  H, Jóźwik M. Urinary tract infections during
pregnancy – An updated overview. Dev Period Med 2016;20:263‑72.
10. Amiri F, Rooshan M, Ahmady M, Soliamani M. Hygiene practices
and sexual activity associated with urinary tract infection in
pregnant women. EMHJ‑Eastern Mediterr Health J 2009;15:104‑10.
11. Delzell JE Jr., Lefevre  M. Urinary tract infections during
pregnancy. Am Fam Phys 2000;61:713‑20.
12. Alemu A, Moges F, Shiferaw Y, Tafess K, Kassu A, Anagaw B, et al.
Bacterial profile and drug susceptibility pattern of urinary tract
infection in pregnant women at university of Gondar teaching
hospital, northwest Ethiopia. BMC Res Notes 2012;5:197.
13. Nezhad Sadeghi E, Solhi M. Effect of education based on health
belief model on prevention of urinary infection in pregnant Health
Med 2012;6:4211‑7.
14. Tadesse  E, Teshome  M, Merid  Y, Kibret  B, Shimelis  T.
Asymptomatic urinary tract infection among pregnant women
attending the antenatal clinic of Hawassa referral hospital,
southern Ethiopia. BMC Res Notes 2014;7:155.
15. Schnarr J, Smaill F. Asymptomatic bacteriuria and symptomatic
urinary tract infections in pregnancy. Eur J Clin Invest
16. Noroozi F, Noroozi A, Tahmasebi R. Influencing factors in the
health promoting behaviors of Urinary system based on health
belief model in pregnant women in Bushehr 2013‑14. ISMJ
17. Derese B, Kedir H, Teklemariam Z, Weldegebreal F, Balakrishnan S.
Bacterial profile of urinary tract infection and antimicrobial
susceptibility pattern among pregnant women attending at
antenatal clinic in dil chora referral hospital, dire dawa, eastern
ethiopia. Ther Clin Risk Manag 2016;12:251‑60.
18. Emiru T, Beyene G, Tsegaye W, Melaku S. Associated risk factors
of urinary tract infection among pregnant women at felege Hiwot
referral hospital, Bahir Dar, North West Ethiopia. BMC Res Notes
19. Alidadi A. Evaluation of knowledge, attitude and behavior in
the field of urinary tract infection among the Iranian pregnant
women, based on the health belief model (HBM): A systematic
review. Int J Adv Multidiscip Res 2018;5:68‑74.
20. Ahmed  NM, Khresheh  RM. Impact of instructional program
about prevention of UTI recurrence on the level of knowledge
and self‑care behaviors among women with UTI in Saudi Arabia.
JNHS 2016;5:43‑51.
21. Hassan  MH. Effect of intervention guidelines on self care
practices of pregnant women with urinary tract infection. Life
Sci J 2015;12:113‑24.
22. Shamsi  M, Roozbehani  N, Kabir  K. Preventive behaviors of
urinary tract infection  (UTI) based on the theory of planned
behavior among pregnant women in Karaj in 2013. Daneshvar
23. dos Santos Fioravante FF, de Carvalho Queluci G. Educational
technology for the prevention of urinary tract infections
during pregnancy: A descriptive study. Online Braz J Nurs
24. Badran YA, El‑Kashef TA, Abdelaziz AS, Mohamad Ali M . Impact
of genital hygiene and sexual activity on urinary tract infection
during pregnancy. Urol Ann 2015;7:478.
25. Nikpour S, Tabrizian L, Masroor Roodsari D, Hghani H. Study
of predisposing factors of urinary tract infections among married
women referred to selected hospitals in Tehran city. Razi J Med
Sci 2004;11:489‑97.[In Persian].
26. Sabouri M, Shakibazadeh E, Mohebbi B, Tol A, Yaseri M, Babaee S.
Effectiveness of an educational intervention using theory of
planned behavior on health care empowerment among married
reproductive‑age women: A randomized controlled trial. J Edu
Health Promot 2020;9:293.
27. Gonzalez G, Vaculik K, Khalil C, Zektser Y, Arnold C, Almario CV,
et al. Women’s experience with stress urinary incontinence:
Insights from social media analytics. J Urol 2020;203:962‑8.
28. Indhumol T, Pavithran S, George LK. Effectiveness of structured
teaching program on knowledge regarding prevention of urinary
tract infection among adolescent girls. Int J Pharm Med Bio Sci
29. Heshmati H, Behnampour N, Mir M, Karimi F, Khajavi S. Factors
associated with urine and genital tract infection preventive
behaviors among women referred to Gorgan Health Centers
based on health belief model. Iran J Health Educ Health Promot
2015;3:59‑68.[In Persian].
30. Song  KJ. The effects of self‑efficacy promoting cardiac
rehabilitation program on self‑efficacy, health behavior, and
quality of life. Taehan Kanho Hakhoe Chi 2003;33:510‑8.
31. Conner  M, Higgins  AR. Long‑term effects of implementation
intentions on prevention of smoking uptake among adolescents:
A  cluster randomized controlled trial. Health Psychol