Wassenaar E L, Lont F, Verhoeven C J, Henrichs J, Titulaer Lml, Warmelink J C, Geerts C C
Midwifery Academy Amsterdam Groningen, Inholland, Amsterdam, the Netherlands.
Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands.
BMC Pregnancy Childbirth. 2024 Dec 20;24(1):838. doi: 10.1186/s12884-024-06918-w.
After childbirth, women often experience changes in sexual health. Little is known about the associated factors for the development of sexual health problems. Therefore, in this study we aim to investigate (1) how many women report changes in sexual health; (2) the prevalence and associated factors of women's postpartum sexual health problems and (3) whether women want to be better informed about postpartum sexual health after childbirth.
From March to May 2021, 641 postpartum Dutch women participated in a cross-sectional study through an online survey, distributed via social media. At a mean time of 11.6 months (SD = 6.23) after birth, women reported information on maternal, pregnancy and childbirth characteristics and childbirth experience, sexual dysfunction (Female Sexual Function Index), sexual distress (Female Sexual Distress Scale), relationship satisfaction (Relationship Assessment Scale) and "perceived need for information" to discuss sexual health with their maternity care provider.
Postpartum changes in sexual health were found in 88% of women. Of the women who participated, 43.7% reported sexual dysfunction and 52.3% reported sexual distress. Overall, 46% of women perceived more need for information. Multivariable logistic regression analyses showed that negative sexual experiences were associated with increased odds of sexual dysfunction (odds ratio (OR) 1.58, 95% CI 1.04-2.40) and sexual distress (OR 1.70, 1.17-2.46). Perineal damage (OR 1.54, 1.03-2.29) was associated with increased odds of sexual dysfunction, and a BMI ≥ 30 kg/m (OR 0.46, 0.28-0.70) was associated with decreased odds of sexual dysfunction. A higher level of relationship satisfaction was associated with decreased odds of sexual dysfunction (OR 0.36, 0.25-0.51) and sexual distress (OR 0.47, 0.35-0.63). A positive childbirth experience was associated with decreased odds of sexual distress (OR 0.88, 0.81-0.96) and decreased odds of "perceived need for information" (OR 0.86, 0.79 to 0.94).
Sexual health problems are experienced by half of postpartum women. Midwives should inform women and their partners about these possible problems, taking into account birth-related factors, e.g. birth experience and perineal damage. Care providers should pay special attention to women with negative sexual experiences.
分娩后，女性的性健康状况常发生变化。关于性健康问题发展的相关因素，我们知之甚少。因此，在本研究中，我们旨在调查：（1）有多少女性报告了性健康方面的变化；（2）女性产后性健康问题的患病率及相关因素；（3）女性是否希望在产后更好地了解产后性健康知识。
2021年3月至5月，641名荷兰产后女性通过社交媒体分发的在线调查参与了一项横断面研究。在产后平均11.6个月（标准差=6.23）时，女性报告了有关母亲、怀孕和分娩特征、分娩经历、性功能障碍（女性性功能指数）、性困扰（女性性困扰量表）、关系满意度（关系评估量表）以及与产科护理人员讨论性健康的“信息需求感知”等信息。
88%的女性存在产后性健康变化。参与调查的女性中，43.7%报告存在性功能障碍，52.3%报告存在性困扰。总体而言，46%的女性认为更需要信息。多变量逻辑回归分析表明，负面性经历与性功能障碍（优势比[OR]1.58，95%置信区间1.04-2.40）和性困扰（OR 1.70，1.17-2.46）的几率增加相关。会阴损伤（OR 1.54，1.03-2.29）与性功能障碍几率增加相关，体重指数≥30 kg/m（OR 0.46，0.28-0.70）与性功能障碍几率降低相关。更高的关系满意度与性功能障碍（OR 0.36，0.25-0.51）和性困扰（OR 0.47，0.35-0.63）的几率降低相关。积极的分娩经历与性困扰几率降低（OR 0.88, 0.81-0.96）和“信息需求感知”几率降低（OR 0.86, 0.79至0.94）相关。
一半的产后女性存在性健康问题。助产士应告知女性及其伴侣这些可能的问题，同时考虑与分娩相关的因素，如分娩经历和会阴损伤。护理人员应特别关注有负面性经历的女性。
