Lagaert Liesbet, Weyers Steven, Van Kerrebroeck Helena, Elaut Els
a Department of Medicine, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.
b Department of Obstetrics and Gynaecology , Ghent University Hospital , Ghent , Belgium.
Eur J Contracept Reprod Health Care. 2017 Jun;22(3):200-206. doi: 10.1080/13625187.2017.1315938. Epub 2017 Apr 27.
Sexual functioning is an important concern for women in the postpartum period. The aim of this research was to investigate the prevalence and determinants of dyspareunia and sexual dysfunction before and after childbirth.
Between November 2013 and April 2014, 109 women in their third trimester of pregnancy were enrolled in a prospective cohort study at Ghent University Hospital. Dyspareunia, sexual functioning and quality of life (QOL) were evaluated at enrolment and again 6 weeks and 6 months postpartum. Sexual functioning and QOL were assessed using validated self-report questionnaires: the Female Sexual Function Index and the Short Form-36 health survey. Dyspareunia was evaluated by a specific self-developed questionnaire.
One hundred and nine women were enrolled; respectively, 71 (65.1%), 66 (60.6%) and 64 (58.7%) women returned the questionnaires prepartum, and 6 weeks and 6 months postpartum. Sexual functioning at 6 weeks was predictive of sexual functioning at 6 months postpartum (r = 0.345, p = .015). The prevalence of dyspareunia in the third trimester of pregnancy, and 6 weeks and 6 months postpartum was, respectively, 32.8%, 51.0% and 40.7%. The severity of pain decreased significantly between 6 weeks and 6 months postpartum (p = .003). In the first 6 weeks postpartum, the degree of dyspareunia was significantly associated with breastfeeding (p = .045) and primiparity (p = .020). At 6 months, only the association with primiparity remained significant (p = .022).
The impaired postpartum sexual functioning, the high prevalence of dyspareunia postpartum and their impact on QOL indicate the need for further investigation and extensive counselling of pregnant women, especially primiparous women, about sexuality after childbirth.
性功能是产后女性的一个重要关注点。本研究的目的是调查分娩前后性交困难和性功能障碍的患病率及决定因素。
2013年11月至2014年4月期间，109名妊娠晚期妇女在根特大学医院参加了一项前瞻性队列研究。在入组时以及产后6周和6个月再次评估性交困难、性功能和生活质量（QOL）。性功能和生活质量使用经过验证的自我报告问卷进行评估：女性性功能指数和简短36项健康调查。性交困难通过一份专门自行编制的问卷进行评估。
109名妇女入组；分别有71名（65.1%）、66名（60.6%）和64名（58.7%）妇女在产前、产后6周和6个月返回了问卷。产后6周时的性功能可预测产后6个月时的性功能（r = 0.345，p = 0.015）。妊娠晚期、产后6周和6个月时性交困难的患病率分别为32.8%、51.0%和40.7%。产后6周和6个月之间疼痛严重程度显著降低（p = 0.003）。在产后的前6周，性交困难的程度与母乳喂养（p = 0.045）和初产（p = 0.020）显著相关。在6个月时，仅与初产的关联仍然显著（p = 0.022）。
产后性功能受损、产后性交困难的高患病率及其对生活质量的影响表明，需要对孕妇，尤其是初产妇，进行关于产后性方面的进一步调查和广泛咨询。
