Predictors for sexual dysfunction in the first year postpartum: A systematic review and meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Sexual Health Research
• Pelvic Floor Disorders

Background:

• Pregnancy and childbirth are known risk factors for pelvic floor dysfunction, including sexual dysfunction.
• The specific mechanisms and contributing risk factors for postpartum sexual dysfunction remain unclear.

Purpose of the Study:

• To systematically review the literature and identify risk factors for sexual dysfunction within the first year after childbirth.

Main Methods:

• A systematic literature search was conducted in MEDLINE, Embase, and CENTRAL.
• Included studies were original, comparative, in English, using validated questionnaires and standardized terminology for sexual dysfunction.
• Quality assessment and risk of bias were performed using the Newcastle-Ottawa scale, with random-effects meta-analysis for data synthesis.

Main Results:

• Anal sphincter injury was linked to higher odds of sexual dysfunction (OR 3.00) and dyspareunia (OR 1.92).
• Episiotomy was associated with dyspareunia (OR 1.64) but not sexual dysfunction.
• Instrumental vaginal birth increased sexual dysfunction odds (OR 1.70), while Cesarean section reduced dyspareunia odds (OR 0.68).

Conclusions:

• Perineal trauma is a significant risk factor for postpartum sexual dysfunction and dyspareunia.
• The mode of birth appears less influential on sexual dysfunction compared to the occurrence of perineal trauma.