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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