Dyspareunia and childbirth: a prospective cohort study

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Maternal Morbidity

Background:

• Dyspareunia, or painful sexual intercourse, is a common postpartum maternal morbidity.
• The mode of delivery and associated perineal trauma may significantly influence the occurrence of dyspareunia.

Purpose of the Study:

• To investigate the relationship between mode of delivery, perineal trauma, and the incidence of dyspareunia.
• To identify specific delivery methods associated with a higher risk of postpartum dyspareunia.

Main Methods:

• A prospective cohort study involving 1507 nulliparous women across six maternity hospitals in Melbourne, Australia.
• Data collected via questionnaires at baseline and 3, 6, 12, and 18 months postpartum.
• Univariable and multivariable logistic regression analyses were used to assess associations.

Main Results:

• At 18 months postpartum, 24% of women reported dyspareunia.
• Emergency caesarean section (aOR 2.41) and vacuum extraction (aOR 2.28) were significantly associated with increased odds of dyspareunia compared to spontaneous vaginal delivery with an intact perineum.
• Elective caesarean section also showed a trend towards increased dyspareunia (aOR 1.71).

Conclusions:

• Obstetric interventions, including caesarean sections and instrumental deliveries, are associated with persistent dyspareunia.
• Increased recognition of the impact of delivery mode and perineal trauma on postpartum health is needed.
• Further research into preventing postpartum dyspareunia is warranted.