Doke Prakash Prabhakarrao, Vaidya Varsha Mahesh, Narula Arvinder Pal Singh, Patil Archana Vasantrao, Panchanadikar Tushar Madhavrao, Wagh Girija Narendra
Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India.
Health Services, Government of Maharashtra, Pune, Maharashtra, India.
J Family Med Prim Care. 2021 Jul;10(7):2600-2607. doi: 10.4103/jfmpc.jfmpc_2482_20. Epub 2021 Jul 30.
Many women have postpartum sexual dysfunction. The mode of delivery is an important determinant.
To calculate the risk ratio of non-resumption of vaginal sex and dyspareunia during the postpartum period among cesarean-delivered women.
This large multisite study was conducted in 13 selected hospitals in Pune District during 2017-19.
A total of 3,112 women (half cesarean delivered and half vaginally) were interviewed by trained health workers using a structured questionnaire. Women were interviewed at 4 weeks, 6 weeks, and 6 months.
Chi-square test was applied. A risk ratio with a 95% confidence interval was calculated.
At 6 weeks, the risk ratio of non-resumption of vaginal sex was significantly high among cesarean-delivered participants (1.14). Cesarean-delivered women had a lesser risk ratio of dyspareunia at both follow-ups (0.59, 0.49). Even at 6 months, about one-third vaginally delivered women had dyspareunia. The proportion of women non-resuming vaginal sex gradually decreased from 6 weeks to 6 months. The proportion of women having dyspareunia also decreased from 6 weeks to 6 months following childbirth. Residence in the rural area and cesarean delivery were the significant determinants of an early resumption of vaginal sex. Dyspareunia was significantly high among vaginal delivered than cesarean. About 25% of women continued to have dyspareunia up to 6 months.
A large number of women suffer from dyspareunia; hence antenatal and postnatal care should include some counseling and management about the resumption of sex and dyspareunia.
许多女性存在产后性功能障碍。分娩方式是一个重要的决定因素。
计算剖宫产女性产后期间未恢复阴道性交及性交困难的风险比。
这项大型多中心研究于2017 - 2019年在普纳地区的13家选定医院进行。
共有3112名女性（一半剖宫产，一半经阴道分娩）由经过培训的卫生工作者使用结构化问卷进行访谈。在4周、6周和6个月时对女性进行访谈。
应用卡方检验。计算95%置信区间的风险比。
在6周时，剖宫产参与者中未恢复阴道性交的风险比显著较高（1.14）。在两次随访中，剖宫产女性性交困难的风险比均较低（0.59，0.49）。即使在6个月时，约三分之一经阴道分娩的女性仍有性交困难。未恢复阴道性交的女性比例从6周逐渐下降至6个月。产后有性交困难的女性比例也从6周下降至6个月。农村居住和剖宫产是早期恢复阴道性交的重要决定因素。经阴道分娩的女性性交困难的发生率显著高于剖宫产女性。约25%的女性直至6个月仍有性交困难。
大量女性存在性交困难；因此产前和产后护理应包括一些关于恢复性生活及性交困难的咨询和管理。
