Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.
Department of Obstetrics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.
BMC Pregnancy Childbirth. 2017 Dec 6;17(1):408. doi: 10.1186/s12884-017-1583-2.
Up to now, there is controversy over the effect of delivery mode cesarean delivery and spontaneous vaginal delivery on sexual function. Therefore, we did a systematic review and meta-analysis in postpartum women to explore the mode of delivery, cesarean delivery, and spontaneous vaginal delivery and differences in postpartum sexual function (short- and long-term) in Chinese primiparous women.
Comprehensive electronic searches of PubMed, EMBASE, Web of Science, Elsevier Science Direct, Cochrane Library, the Chinese Biological Medical Literature database and the Chinese National Knowledge Infrastructure database were conducted to identify any study in each database published to August 31, 2017. The primary outcome was the sexual satisfaction and the secondary outcomes were resumed intercourse and sexual pain in the postpartum.
We identified 10 studies with a total population of 2851 in the present meta-analysis. Five and six eligible articles were respectively included for sexual satisfaction in postpartum at 3- and 6 months. Compared with vaginal delivery group, two time points were all not found statistically significance (OR 1.53, 95%CI 0.93-2.49; OR 1.15, 95%CI 0.95-1.39, respectively) in cesarean and spontaneous vaginal delivery group; in resumed intercourse and sexual pain domains, they were all significantly, with an overall OR of 2.05 (95%CI 1.36-3.11) at 3 months, 1.50 (95%CI 1.04-2.16) at 6 months and 0.29 (95%CI 0.24, 0.36) at 3 months, 0.73 (95%CI 0.58, 0.93) at 6 months, respectively. With the passage of time, the gap was closing. Sensitivity analysis was indicated a good stability of the meta-analysis in each domain.
In conclusion, this meta-analysis indicated that the mode of delivery, cesarean and spontaneous vaginal delivery did not affect postpartum sexual satisfaction (short- and long-term) and appeared to have minimal effect on the long-term resumed intercourse and sexual pain in Chinese primiparous women. Primiparous women should be more cautious to choose cesarean section in order to preserve sexual function.
迄今为止，关于分娩方式剖宫产和自然阴道分娩对性功能的影响仍存在争议。因此，我们在产后妇女中进行了系统评价和荟萃分析，以探讨中国初产妇的分娩方式、剖宫产和自然阴道分娩以及产后短期和长期性功能（包括性满意度、恢复性交和性疼痛）的差异。
全面检索 PubMed、EMBASE、Web of Science、Elsevier Science Direct、Cochrane Library、中国生物医学文献数据库和中国知网，检索每个数据库截至 2017 年 8 月 31 日的所有研究。主要结局为性满意度，次要结局为产后 3 个月和 6 个月恢复性交和性疼痛。
本荟萃分析共纳入 10 项研究，总计 2851 例患者。有 5 项和 6 项研究分别纳入产后 3 个月和 6 个月的性满意度。与阴道分娩组相比，剖宫产组和自然阴道分娩组在两个时间点均无统计学意义（OR 1.53，95%CI 0.93-2.49；OR 1.15，95%CI 0.95-1.39）；在恢复性交和性疼痛方面，两组均有显著差异，总体 OR 值分别为 3 个月时 2.05（95%CI 1.36-3.11）、6 个月时 1.50（95%CI 1.04-2.16）、3 个月时 0.29（95%CI 0.24,0.36）、6 个月时 0.73（95%CI 0.58,0.93）。随着时间的推移，差距逐渐缩小。敏感性分析表明各领域的荟萃分析均具有较好的稳定性。
综上所述，本荟萃分析表明，分娩方式、剖宫产和自然阴道分娩并不影响产后短期和长期的性满意度，并且似乎对中国初产妇的长期恢复性交和性疼痛影响较小。初产妇为了保持性功能应更加谨慎地选择剖宫产。
