Abstract
BackgroundUp to now, there is controversy over the effect of delivery mode cesarean delivery and spontaneous vaginal delivery on sexual function. Therefore, we did a systematic review and meta-analysis in postpartum women to explore the mode of delivery, cesarean delivery, and spontaneous vaginal delivery and differences in postpartum sexual function (short- and long-term) in Chinese primiparous women.MethodsComprehensive electronic searches of PubMed, EMBASE, Web of Science, Elsevier Science Direct, Cochrane Library, the Chinese Biological Medical Literature database and the Chinese National Knowledge Infrastructure database were conducted to identify any study in each database published to August 31, 2017. The primary outcome was the sexual satisfaction and the secondary outcomes were resumed intercourse and sexual pain in the postpartum.ResultsWe identified 10 studies with a total population of 2851 in the present meta-analysis. Five and six eligible articles were respectively included for sexual satisfaction in postpartum at 3- and 6 months. Compared with vaginal delivery group, two time points were all not found statistically significance (OR 1.53, 95%CI 0.93–2.49; OR 1.15, 95%CI 0.95–1.39, respectively) in cesarean and spontaneous vaginal delivery group; in resumed intercourse and sexual pain domains, they were all significantly, with an overall OR of 2.05 (95%CI 1.36–3.11) at 3 months, 1.50 (95%CI 1.04–2.16) at 6 months and 0.29 (95%CI 0.24, 0.36) at 3 months, 0.73 (95%CI 0.58, 0.93) at 6 months, respectively. With the passage of time, the gap was closing. Sensitivity analysis was indicated a good stability of the meta-analysis in each domain.ConclusionsIn conclusion, this meta-analysis indicated that the mode of delivery, cesarean and spontaneous vaginal delivery did not affect postpartum sexual satisfaction (short- and long-term) and appeared to have minimal effect on the long-term resumed intercourse and sexual pain in Chinese primiparous women. Primiparous women should be more cautious to choose cesarean section in order to preserve sexual function.
Highlights
Up to now, there is controversy over the effect of delivery mode cesarean delivery and spontaneous vaginal delivery on sexual function
In another similar cross-sectional study of primiparous women [35], Hosseini et al reported that women in the normal vaginal delivery group and planned cesarean section group had no significant difference in the sexual function, including sexual satisfaction and pain, and he appealed that undergoing planned cesarean section in order to preserve sexual function was not recommended
Because most Chinese doctors just focus on the three domains, we cannot assess all of the domains of their postpartum sexual problems. This meta-analysis indicated that the mode of delivery, cesarean delivery, and vaginal delivery did not affect postpartum sexual satisfaction and appeared to have minimal effect on the long-term resumed intercourse and sexual pain in Chinese primiparous women
Summary
There is controversy over the effect of delivery mode cesarean delivery and spontaneous vaginal delivery on sexual function. We did a systematic review and meta-analysis in postpartum women to explore the mode of delivery, cesarean delivery, and spontaneous vaginal delivery and differences in postpartum sexual function (short- and long-term) in Chinese primiparous women. There has been concern about progressively increasing rates of caesarean section in many parts of the world, among developing countries such as China [1, 2]. Long-term consequences associated with caesarean sections had been reported in many previous studies, including pelvic floor disorders, reduced fertility, placental abnormalities, mental distress, and female sexual dysfunction [5,6,7]. Available data suggested that postpartum female sexual dysfunction was common in many countries [8,9,10].
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