Kahramanoglu Ilker, Baktiroglu Merve, Hamzaoglu Kubra, Kahramanoglu Ozge, Verit Fatma Ferda, Yucel Oguz
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty Istanbul University, Fatih, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.
Arch Gynecol Obstet. 2017 Apr;295(4):907-916. doi: 10.1007/s00404-017-4299-7. Epub 2017 Feb 6.
The purpose of this study was to evaluate the impact of mode of delivery on the sexual function of women using the Female Sexual Function Index (FSFI).
This was a prospective study of 452 nulliparous women, comparing their sexual function before and after birth. A Turkish version of the FSFI questionnaire was administered within the first 8 weeks of pregnancy, at 3 and 6 months postpartum in a face-to-face manner and subsequently at the 12th month and 24th month over the telephone.
Age, BMI, education level, house income, duration of marriage, birthweight, and feeding at each time point were similar between group 1 [vaginal birth and mediolateral episiotomy (MLE)] and group 2 [caesarean section (CS)]. In the postpartum period, there were 265 and 138 participants at 3rd month, 216 and 121 participants at 6th month, 189 and 111 participants at 12th month, and 133 and 85 participants at 24th month in group 1 and 2, respectively. The FSFI total scores decreased at 3 and 6 months postpartum in both groups (27.3 to 23.1 in group 1 and 27.5 to 25 in group 2; p < 0.05 for both). Desire, arousal, lubrication, satisfaction and pain scores were significantly decreased at 3 months postpartum in group (1) In group 1, desire, arousal and pain scores remained decreased at the 6th month compared to initial scores. Group 2 had significantly lower desire, lubrication, satisfaction and pain scores at 3 months postpartum compared to their initial scores. Decline in desire and lubrication domains persisted at the 6th month for group (2) None of the FSFI domain scores differed after 6th months when compared to pre-delivery scores in both groups. Compared with the caesarean group, the vaginal birth with MLE group had lower satisfaction and higher pain levels at 3 months postpartum (p < 0.0001, for both). None of the FSFI domains differed at the 6th, 12th or the 24th month between the groups.
Our study revealed that caesarean section is not superior to vaginal birth in terms of preservation of normal sexual function, regardless of short-term postpartum effects. Women should be informed that, irrespective of their type of delivery, sexual function 6 months after childbirth is similar to that in pre-pregnancy.
本研究旨在使用女性性功能指数（FSFI）评估分娩方式对女性性功能的影响。
这是一项对452名未生育女性的前瞻性研究，比较她们分娩前后的性功能。在怀孕的前8周内、产后3个月和6个月以面对面的方式发放土耳其语版的FSFI问卷，随后在第12个月和第24个月通过电话进行调查。
第1组[阴道分娩加会阴侧切术（MLE）]和第2组[剖宫产（CS）]在每个时间点的年龄、体重指数、教育水平、家庭收入、婚姻持续时间、出生体重和喂养情况相似。在产后阶段，第1组和第2组在第3个月分别有265名和138名参与者，第6个月分别有216名和121名参与者，第12个月分别有189名和111名参与者，第24个月分别有133名和85名参与者。两组在产后3个月和6个月时FSFI总分均下降（第1组从27.3降至23.1，第2组从27.5降至25；两组均p<0.05）。第1组在产后3个月时性欲、性唤起、润滑、满意度和疼痛评分显著下降。在第1组中，与初始评分相比，第6个月时性欲、性唤起和疼痛评分仍下降。第2组在产后3个月时性欲、润滑、满意度和疼痛评分与初始评分相比显著降低。第2组在第6个月时性欲和润滑领域的下降仍然存在。两组在第6个月后与分娩前评分相比，FSFI各领域评分均无差异。与剖宫产组相比，阴道分娩加会阴侧切术组在产后3个月时满意度较低，疼痛水平较高（两者均p<0.0001）。两组在第6、12或24个月时FSFI各领域均无差异。
我们的研究表明，无论产后短期影响如何，在保留正常性功能方面剖宫产并不优于阴道分娩。应告知女性，无论其分娩方式如何，产后6个月的性功能与怀孕前相似。
