Sexual Function After Obstetric Anal Sphincter Injuries (OASIs): A Systematic Review and Meta-Analysis

Area of Science:

• Obstetrics and Gynecology
• Sexual Health Research
• Evidence Synthesis

Background:

• Obstetric anal sphincter injuries (OASIs) can lead to severe, life-altering complications.
• Postpartum sexual dysfunction is a significant concern for women's quality of life.

Purpose of the Study:

• To investigate the independent effect of sustaining an OASI on postpartum sexual function.
• To synthesize existing evidence on the relationship between OASI and sexual health outcomes.

Main Methods:

• Systematic literature search of MEDLINE, Embase, and Cochrane Library up to July 2024.
• Inclusion of studies comparing vaginal delivery with and without OASI.
• Data extraction and risk of bias assessment by two independent reviewers; random-effects meta-analysis used for pooled estimates.

Main Results:

• Twenty-two studies were included, providing low-certainty evidence.
• Women with OASI showed a 30% reduced likelihood of sexual activity at 3 months postpartum.
• Increased likelihood of dyspareunia at 3 months (RR 1.58) and >12 months (RR 1.69) postpartum was observed in women with OASI.

Conclusions:

• Current evidence is observational and heterogeneous, limiting causal inference.
• Quantitative findings are exploratory; high-quality prospective studies are required.
• Proactive discussion of sexual health during postnatal follow-up for OASI patients is recommended.