An Epidemiological Study of Pyuria and Associated Behavioral Hygiene Practices Among Pregnant Women Attending Primary Health Care Centers in Al-Hillah City

Background & Objective: Pyuria during pregnancy poses significant maternal and fetal health risks. This study aimed to identify clinical manifestations, behavioral hygiene practices, and epidemiological factors associated with significant pyuria among pregnant women attending Primary Healthcare Centers (PHCs) in Al-Hillah City, Iraq.Materials & Methods: A descriptive cross-sectional study was conducted across 22 PHCs in Al-Hillah City from December 2025 to April 2026, enrolling 450 pregnant women. Data were collected via a structured questionnaire and General Urine Examination (significant pyuria:≥20 pus cells/HPF). Statistical analysis was performed using SPSS version 29.0 using Pearson’s Chi-square test and multivariable logistic regression.Results: Participants were predominantly housewives (86.9%) and overweight or obese (66.7%). Significant pyuria was strongly associated with dysuria (100%), increased urinary frequency (99.3%), nocturia (99.3%), and vaginal itching (94.8%) (P<0.05). Multivariable analysis revealed that delaying post-coital intimate washing by 5-10 minutes was a significant independent risk factor (AOR=5.308, 95% CI: 2.333-12.078, P<0.001), whereas regular physical activity was an independent protective factor (AOR=0.057, 95% CI: 0.031-0.104, P<0.001). Fever or chills remained an independent clinical predictor (AOR=0.057, P<0.001).Conclusion: Significant pyuria is highly symptomatic and strongly linked to hygiene-related behavioral gaps, notably delayed post-coital washing. Routine antenatal care at primary healthcare centers should integrate targeted hygiene counseling, physical activity promotion, and early clinical symptom triage.