MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
BJOG. 2022 Nov;129(12):2010-2018. doi: 10.1111/1471-0528.17262. Epub 2022 Aug 3.
To investigate the association between mode of delivery and subsequent maternal sexual wellbeing.
Prospective birth cohort study.
Avon (in Bristol area), UK.
Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC).
Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety.
Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum.
We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97-1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88-1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46-2.08).
These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.
探讨分娩方式与产妇后续性健康之间的关系。
前瞻性出生队列研究。
英国布里斯托尔地区的埃文（Avon）。
阿冯纵向研究父母和孩子（ALSPAC）的参与者。
分娩方式从产科记录中提取，性健康测量通过自我报告问卷收集。使用多重插补法处理缺失数据，对于分类有序结局，使用有序逻辑回归模型调整了产妇分娩时的年龄、孕前体重指数、孕期糖尿病、社会经济地位、产次、抑郁和焦虑等协变量。
产后 4 个时间点（33 个月至 18 岁）的性愉悦度和频率，以及产后 11 年的 2 种与性相关的疼痛（阴道性交时疼痛和性交后其他部位疼痛）。
我们没有发现分娩方式与性愉悦度（例如，33 个月时调整后的优势比[OR]1.11，95%置信区间[95%CI]0.97-1.27）或性频率（OR 0.99，95%CI 0.88-1.12，33 个月时）之间存在关联。与阴道分娩相比，剖宫产在调整后的模型中与产后 11 年阴道性交时疼痛的几率增加相关（OR 1.74，95%CI 1.46-2.08）。
这些发现没有提供证据支持剖宫产与性愉悦度或频率之间存在关联。然而，分娩方式与性交困难有关，这可能不仅限于腹部疤痕。
