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Predictors for sexual dysfunction in the first year postpartum: a systematic review and meta-analysis
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  • Laura Cattani,
  • Liza De Maeyer,
  • Jan Verbakel,
  • Jan Bosteels,
  • Jan Deprest
Laura Cattani
Katholieke Universiteit Leuven UZ Leuven
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Liza De Maeyer
KU Leuven Biomedical Sciences Group
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Jan Verbakel
Katholieke Universiteit Leuven UZ Leuven
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Jan Bosteels
Katholieke Universiteit Leuven UZ Leuven
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Jan Deprest
Universitaire Ziekenhuizen Leuven
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Abstract

Background Pregnancy and childbirth increase the risk for pelvic floor dysfunction, including sexual dysfunction. So far, the mechanisms and the extent to which certain risk factors play a role, remain unclear. Objectives In this systematic review of literature, we aimed to determine the risk factors for sexual dysfunction in the first year after delivery. Search Strategy We searched MEDLINE, Embase and CENTRAL using the search strategy: Sexual dysfunction AND Obstetric events. Selection Criteria We included original English, comparative studies that used validated questionnaires and the ICS/IUGA terminology for sexual dysfunction, dyspareunia and vaginal dryness. Data Collection and Analysis We assessed the quality and the risk of bias of the included studies with the Newcastle Ottawa Scale. We extracted the reported data and we performed random-effects meta-analysis to obtain the summary Odds Ratios (OR) with 95% Confidence Intervals. Heterogeneity across studies was assessed using the I2 statistic. Main Results We found no significant difference in the odds for both sexual dysfunction and dyspareunia between cesarean section and spontaneous delivery (OR:1.17[0.88-1.57] and OR:0.75[0.53-1.07]) and between operative delivery and spontaneous delivery (OR:1.56[0.87-2.79] and OR:1.35[0.75-2.42]). Anal sphincter injury was associated with increased odds for both sexual dysfunction (OR:3.00[1.28-7.03]) and dyspareunia (OR:1.71[1.09-2.67]). Episiotomy was associated with dyspareunia (OR:1.65[1.20-2.29]) but not with sexual dysfunction (OR:1.90[0.94-3.84]). We retrieved one study of low quality which reported on vaginal dryness and found no significant association with obstetric events.

Peer review status:UNDER REVIEW

11 Jan 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
19 Jan 2021Assigned to Editor
19 Jan 2021Submission Checks Completed
14 Feb 2021Reviewer(s) Assigned
03 Jun 2021Review(s) Completed, Editorial Evaluation Pending