Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla; Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Nigeria.
Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus; Department of Obstetrics and Gynaecology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.
Niger J Clin Pract. 2023 May;26(5):636-645. doi: 10.4103/njcp.njcp_119_23.
Studies are abound from low- and middle-income countries (LMICs) on postpartum sexual dysfunction but very limited in pregnancy. The data will help clinicians in providing women with evidence-based information and counseling in these regards.
To determine the effects of different trimesters of pregnancy on sexual functions and the possible risk factors for sexual dysfunction in pregnancy.
The study was longitudinal in design, and study population consisted of 270 pregnant women attending antenatal care at the two largest tertiary hospitals in Enugu, Nigeria. The recruitment was in the first trimester, and each recruited participant served as her own control. Interviews were conducted at specific times in the three trimesters, and data regarding sexual functions were obtained using validated questionnaires. Analysis of variance (ANOVA) was performed to compare the mean total and domain female sexual function index (FSFI) scores between the three trimesters, and Bonferroni's test for significant association between any two trimesters as may be applicable. The risk factors were determined via multivariate logistic regression analysis. A P value ≤0.05 was considered statistically significant.
The FSFI means total score decreased as pregnancy advanced. It was significantly lower in second trimester (T2) than in first trimester (T1) (P < 0.001), and significantly lower in third trimester (T3) than T1 (P < 0.001), but no difference between T3 and T2 (P = 0.759). Similarly, the mean frequency of coitus per week declined across the trimesters; lower in T2 than T1 (2.2 ± 0.7 vs. 2.4 ± 0.6; P < 0.01), and lower in T3 than T1, but no difference between T3 and T2. The overall rate of sexual dysfunction was 50.7% and the risk factors age ≥35 years (AdjOR: 1.4; 95%CI: 1.1-1.9; P: 0.01), multiparity (AdjOR: 1.7; 95%CI: 1.2-2.5; P: 0.013) and a previous history of cesarean section (AdjOR: 2.1; 95%CI: 1.7-2.6; P: 0.004).
Sexual function declines as pregnancy advances and the rate of sexual dysfunction is high in Enugu, Nigeria. Obstetricians are encouraged to discuss sexual health issues during antenatal care services and make more efforts towards reducing the modifying obstetric risk factors.
低中等收入国家（LMICs）有大量关于产后性功能障碍的研究，但关于孕期的研究非常有限。这些数据将帮助临床医生为这些方面的女性提供基于证据的信息和咨询。
确定孕期不同阶段对性功能的影响，以及孕期性功能障碍的可能危险因素。
这项研究是纵向设计的，研究人群包括在尼日利亚恩古尼的两家最大的三级医院接受产前护理的 270 名孕妇。招募工作在孕早期进行，每个被招募的参与者都作为自己的对照。在三个孕期的特定时间进行访谈，并使用经过验证的问卷获得有关性功能的数据。采用方差分析（ANOVA）比较三个孕期的女性性功能综合指数（FSFI）总分和各领域的平均值，如有必要，采用 Bonferroni 检验比较任意两个孕期之间的显著关联。通过多变量逻辑回归分析确定危险因素。P 值≤0.05 被认为具有统计学意义。
FSFI 总分随着妊娠的进展而降低。与孕早期（T1）相比，孕中期（T2）显著降低（P<0.001），与 T1 相比，孕晚期（T3）显著降低（P<0.001），但 T3 与 T2 之间无差异（P=0.759）。同样，每周性交频率也随着孕期的变化而下降；T2 比 T1 低（2.2±0.7 vs. 2.4±0.6；P<0.01），T3 比 T1 低，但 T3 与 T2 之间无差异。总的性功能障碍发生率为 50.7%，危险因素为年龄≥35 岁（调整优势比：1.4；95%可信区间：1.1-1.9；P=0.01）、多胎妊娠（调整优势比：1.7；95%可信区间：1.2-2.5；P=0.013）和既往剖宫产史（调整优势比：2.1；95%可信区间：1.7-2.6；P=0.004）。
随着妊娠的进展，性功能下降，尼日利亚恩古尼的性功能障碍发生率较高。鼓励妇产科医生在产前保健服务中讨论性健康问题，并努力减少影响性功能的产科危险因素。
