Summary of results
  1. Cesarean section versus vaginal deliveryWe found no significant difference in terms of sexual dysfunction (OR:1.17[0.88-1.57]) or dyspareunia following cesarean section (OR:0.79[0.58-1.07]) or vaginal delivery (Figure 2).
  2. Operative delivery versus spontaneous vaginal deliveryNot all studies discriminated between the type of operative delivery. Therefore, only results for the occurrence of sexual dysfunction are given (OR:1.56[0.87-2.79]). As for dyspareunia, a break down for type of delivery was possible, but again there was no significant difference for any specific type of assisted delivery (Figure 3).
  3. Perineal traumaThe occurrence of 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])(Figure 4, analysis 2.1.1 and 2.1.2). Also episiotomy was associated with an increased odds for dyspareunia (OR:1.65[1.20-2.29]) (Figure 4, analysis 2.1.3 and 2.1.4).
A summary of the total ORs for sexual dysfunction, dyspareunia and vaginal dryness are displayed in Table 1. One can find the forest plots on additional risk factors for sexual dysfunction and dyspareunia are in the supplement (Figures S4-S8).