Preventive Medicine Department, University of São Paulo, São Paulo, Brazil.
J Sex Med. 2013 May;10(5):1343-9. doi: 10.1111/jsm.12092. Epub 2013 Feb 22.
Several factors have been found to be independently associated with decline in sexual activity after delivery. However, the association between depression in pregnancy/postpartum and sexual problems is less clear.
To prospectively evaluate the relationship between depressive/anxiety symptoms (DAS) during the perinatal period and sexual life in the postpartum period.
A prospective cohort study conducted between May 2005 and March 2007 included 831 pregnant women recruited from primary care clinics of the public sector in São Paulo, Brazil. Four groups with DAS during antenatal and postpartum periods were identified using the Self Report Questionnaire (SRQ-20): absence of both antenatal and postpartum DAS; presence of antenatal DAS only; presence of postpartum DAS only; and presence of both antenatal and postpartum DAS. The primary outcome was perception of sexual life decline (SLD) before and after pregnancy/delivery. Crude and adjusted risk ratios (RR), with 95% confidence intervals (95% CI), were calculated using Poisson regression to examine the associations between DAS and SLD.
The main outcome measure of this study is the perception of SLD before and after pregnancy/delivery.
SLD occurred in 21.1% of the cohort. In the multivariable analysis, the following variables were independently associated with SLD: DAS during both pregnancy and postpartum (RR: 3.17 [95% CI: 2.18-4.59]); DAS during only the postpartum period (RR: 3.45 [95% CI: 2.39-4.98]); a previous miscarriage (RR: 1.54 [95% CI: 1.06-2.23]); and maternal age (RR: 2.11 [95% CI: 1.22-3.65]).
Postpartum women with DAS have an increased likelihood for SLD up to 18 months after delivery. Efforts to improve the rates of recognition and treatment of perinatal depression/anxiety in primary care settings have the potential to preserve sexual functioning for low-income mothers.
已有多项研究表明，许多因素与产后性行为活跃度下降有关。然而，孕期和产后的抑郁症状与性问题之间的关联尚不明确。
前瞻性评估围产期抑郁/焦虑症状（DAS）与产后性生活之间的关系。
这是一项于 2005 年 5 月至 2007 年 3 月在巴西圣保罗市公立基层医疗机构开展的前瞻性队列研究，共纳入 831 名孕妇。使用自陈式问卷（SRQ-20）识别出孕期和产后均存在 DAS、仅孕期存在 DAS、仅产后存在 DAS 以及孕期和产后均存在 DAS 的 4 个 DAS 组。主要结局是评估妊娠/分娩前后对性生活质量下降的感知。使用泊松回归计算粗风险比（RR）和 95%置信区间（95%CI），以评估 DAS 与 SLD 之间的关联。
本研究的主要结局是评估妊娠/分娩前后对 SLD 的感知。
该队列中有 21.1%的女性报告存在 SLD。多变量分析显示，以下变量与 SLD 独立相关：孕期和产后均存在 DAS（RR：3.17 [95%CI：2.18-4.59]）；仅产后存在 DAS（RR：3.45 [95%CI：2.39-4.98]）；既往流产史（RR：1.54 [95%CI：1.06-2.23]）和产妇年龄（RR：2.11 [95%CI：1.22-3.65]）。
产后 DAS 女性在产后 18 个月内出现 SLD 的可能性增加。在初级保健机构中努力提高对围产期抑郁/焦虑的识别率和治疗率，有可能保护低收入母亲的性功能。
