Risk Factors for Dyspareunia After First Childbirth.
Risk Factors for Dyspareunia After First Childbirth.
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DOI：
10.1097/aog.0000000000001590
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发表时间：
2016-09
影响因子：
7.2
通讯作者：
Repke JT
中科院分区：
文献类型：
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作者：
Alligood-Percoco NR;Kjerulff KH;Repke JT
探讨经产妇性交困难的危险因素。这是一项计划中的二次分析，使用的数据来自2009年至2011年在宾夕法尼亚州分娩第一个孩子的女性的前瞻性研究的产后1个月和6个月访谈。在6个月的访谈中恢复性交的参与者（n = 2，748）构成了分析样本。在6个月时报告性交疼痛的大或中等问题的女性被归类为性交困难。多变量逻辑回归分析用于评估患者特征、产科和心理社会因素以及母乳喂养对性交困难的影响。有583名妇女（21.2%）在产后6个月报告性交困难。近三分之一的母乳喂养者在6个月时报告性交困难（31.5%），而非母乳喂养的妇女为12.7%（校正比值比（校正OR）2.89，95%可信区间（CI）2.33-3.59，P <0.001）; 32.5%的患者在1个月时报告了严重或中度会阴疼痛问题，6个月时报告了性交困难，而没有报告的患者为15.9%（调整后OR 2.45，95%CI 1.93-3.10，P < .001）;在1个月时全部或大部分时间报告疲劳的女性中，28.3%在6个月时报告性交困难，而报告疲劳频率较低的女性中有18.0%（校正OR 1.60，95%CI 1.30-1.98，P < .001）;在产后1个月的压力量表中，24.1%的人在产后6个月时报告性交困难，而在压力量表中得分最低的人中，这一比例为15.6%。（调整后OR 1.55，95% CI 1.18-2.02，P = .001）。在这项前瞻性队列研究中，我们确定了在产后首次访视时可以讨论的经产妇性交困难的特定风险因素，包括母乳喂养，会阴疼痛，疲劳和压力。
To investigate risk factors for dyspareunia among primiparous women. This was a planned secondary analysis, using data from the 1 and 6 month postpartum interviews of a prospective study of women who delivered their first baby in Pennsylvania, 2009 to 2011. Participants who had resumed sexual intercourse by the 6 month interview (n = 2,748) constituted the analytic sample. Women reporting a big or medium problem with painful intercourse at 6 months were categorized as having dyspareunia. Multivariable logistic regression was used to evaluate the effect of patient characteristics, obstetric and psychosocial factors, and breastfeeding on dyspareunia. There were 583 women (21.2%) who reported dyspareunia at 6 months postpartum. Nearly a third of those breastfeeding at 6 months reported dyspareunia (31.5%), versus 12.7% of those not breastfeeding (adjusted odds ratio (adjusted OR) 2.89, 95% confidence interval (CI) 2.33–3.59, P < .001); 32.5% of those reporting a big or medium problem with perineal pain at 1-month reported dyspareunia at 6 months versus 15.9% of those who did not (adjusted OR 2.45, 95% CI 1.93–3.10, P < .001); 28.3% of women who reported fatigue all or most of the time at 1 month reported dyspareunia at 6 months versus 18.0% of those who reported fatigue less often (adjusted OR 1.60, 95% CI 1.30–1.98, P < .001); and 24.1% of those who scored in the upper third on the stress scale at 1 month reported dyspareunia at 6 months postpartum, compared to 15.6% of those who scored in the lowest third (adjusted OR 1.55, 95% CI 1.18–2.02, P = .001). In this prospective cohort study we identified specific risk factors for dyspareunia in primiparous women that can be discussed at the first postpartum visit, including breastfeeding, perineal pain, fatigue and stress.