Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Endocr Disord. 2024 Nov 15;24(1):245. doi: 10.1186/s12902-024-01781-4.
Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap.
This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis.
The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD - 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD - 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD - 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD - 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function.
Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.
妊娠糖尿病（GDM）是一种常见的妊娠并发症，对母婴健康有明确的不良影响。然而，关于其对性健康影响的研究结果并不一致。目前，尚无关于 GDM 孕妇性功能的综合综述。本研究旨在通过系统收集和综合现有证据来填补这一重要的研究空白。
本系统综述和荟萃分析采用了全面的文献检索策略，并纳入了以下数据库：Cochrane 图书馆、Scopus、PubMed、Web of Science、SID 和 Google Scholar。检索截至 2024 年 2 月 21 日。本研究中纳入的横断面和病例对照研究的质量通过改良和标准的 Newcastle-Ottawa 量表进行评估。证据的确定性通过 Grading of Recommendations, Assessment, Development, and Evaluations（GRADE）框架进行评估。进行了元回归分析以检验影响总体性功能的变量。此外，还进行了序贯分析以确定荟萃分析所需的信息量。
系统检索过程共产生了 370 项研究。最终分析纳入了 6 项研究。荟萃分析结果显示，与对照组相比，GDM 女性的总体性功能评分显著较低（SMD-1.80，95%CI-3.44 至-0.15，p=0.03）、性欲（SMD-5.14，95%CI-8.14 至-2.14，p<0.001）、唤起（SMD-0.58，95%CI-0.95 至-0.21，p=0.002）、润滑（MD-0.41，95%CI-0.59 至-0.22，p<0.001）和满意度（SMD-3.82，95%CI-6.08 至-1.57，p<0.001）。然而，分析并未显示 GDM 组和对照组在性疼痛或性高潮方面存在统计学显著差异。元回归分析显示，对照组中年龄较大与性功能较差相关。
与对照组女性相比，诊断为 GDM 的孕妇性功能较低。鉴于证据水平较低，需要进行更大样本量的研究以增强证据的稳健性。医疗保健提供者应关注 GDM 女性的性健康，并制定针对性的干预措施来满足她们的特定需求。
