Corresponding Author
Jan Deprest, MD, PhD, FRCOG
Herestraat 49, B-3000 Leuven
tel. +32 16 34 51 23
fax +32 16 34 42 05
jan.deprest@uzleuven.be
Short running title : Postpartum sexual dysfunction: systematic review
Authors’ contribution to the Manuscript:
L Cattani: protocol development and registration, data collection, data analysis, manuscript writing, other (quality/risk of bias assessment)
L De Maeyer: data collection, data analysis, manuscript writing, other (quality/risk of bias assessment)
J Y Verbakel: manuscript editing, other (supervision of data analysis)
J Bosteels: protocol development, manuscript editing
J Deprest: protocol development, manuscript writing
*LC and LDM contributed equally to this review
FINANCIAL DISCLAIMER/CONFLICT OF INTEREST: J Deprest has received educational grants from GE Medical, which were handled by the KU Leuven Transfer office, which were not for conducting this review. The other authors have no conflicts of interest associated with this publication and there has been no financial support for this work.
This work has been presented on 12th November 2020 as ‘podium presentation’ at the online EUGA meeting 2020.
TOT.WORDS: 2556
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.
Conclusions: Perineal trauma, rather than the mode of delivery, increases the odds for sexual dysfunction in the first year after delivery.
Keywords: sexual dysfunction, dyspareunia, childbirth, delivery, postpartum
Tweetable abstract: Perineal trauma, rather than mode of delivery, correlates with sexual dysfunction postpartum #dyspareunia #OASI #episiotomy
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