School of Nursing, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Women Birth. 2018 Dec;31(6):e403-e411. doi: 10.1016/j.wombi.2018.01.003. Epub 2018 Feb 1.
The association between sexual function and depression has yet to be examined in a prospective cohort study with prolonged postpartum follow-up.
We investigated whether sexual dysfunction predicted depressive symptoms during the 24-month postpartum period and examined the influence of obstetric factors.
This prospective 2-year cohort study with repeated measures included 196 participants who were recruited in a medical center in Taipei, Taiwan (2010-2011). Data on participants' personal characteristics, sexual function, and depression symptoms at 4-6 weeks and at 3, 6, 12, and 24 months postpartum were collected and then assessed using the Female Sexual Function Index and the Center for Epidemiologic Studies Depression Scale.
After adjusting for time and covariates, women with sexual dysfunction had a 1.62-fold (95% confidence interval [CI]: 1.05-2.50-fold) higher estimated odds ratio (OR) for depressive symptoms during the entire 24 months after childbirth than did women without sexual dysfunction. Risk factors for depressive symptoms were a higher pain score (OR: 1.33, 95% CI: 1.13-1.57), a medical condition (OR: 1.65, 95% CI: 1.00-2.73), and severe perineal laceration (OR: 4.67, 95% CI: 1.37-15.92). Sexual satisfaction during the entire 24 months after childbirth (OR: 0.81, 95% CI: 0.70-0.95) and the highest personal income level (OR: 0.33, 95% CI: 0.11-0.99) were factors protecting against higher-scoring depressive symptoms.
Our study provides robust evidence that sexual dysfunction and poor satisfaction, together with severe perineal laceration, greater pain, and a medical condition, predict depressive symptoms during the 24-month postpartum period.
在具有延长产后随访的前瞻性队列研究中，性功能与抑郁之间的关联尚未得到检验。
我们调查了产后 24 个月期间性功能障碍是否预测了抑郁症状，并检查了产科因素的影响。
这是一项为期 2 年的前瞻性队列研究，采用重复测量方法，共纳入 196 名参与者，他们是在台湾台北的一家医疗中心招募的（2010-2011 年）。在产后 4-6 周以及 3、6、12 和 24 个月时收集参与者的个人特征、性功能和抑郁症状的数据，然后使用女性性功能指数和流行病学研究抑郁量表进行评估。
调整时间和协变量后，与没有性功能障碍的女性相比，产后 24 个月期间患有性功能障碍的女性发生抑郁症状的估计比值比（OR）为 1.62 倍（95%置信区间[CI]：1.05-2.50 倍）。抑郁症状的危险因素包括更高的疼痛评分（OR：1.33，95%CI：1.13-1.57）、医疗状况（OR：1.65，95%CI：1.00-2.73）和严重会阴裂伤（OR：4.67，95%CI：1.37-15.92）。产后 24 个月期间的性满意度（OR：0.81，95%CI：0.70-0.95）和最高个人收入水平（OR：0.33，95%CI：0.11-0.99）是预防高评分抑郁症状的因素。
我们的研究提供了有力的证据表明，性功能障碍和较差的满意度，加上严重的会阴裂伤、更大的疼痛和医疗状况，共同预测了产后 24 个月期间的抑郁症状。
