Dyspareunia and childbirth: A prospective cohort study

E. A. McDonald, D. Gartland, Rhonda Small, Stephanie Brown

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective To investigate the relationship between mode of delivery, perineal trauma and dyspareunia. Design Prospective cohort study. Setting Six maternity hospitals in Melbourne, Australia. Sample A total of 1507 nulliparous women recruited in the first and second trimesters of pregnancy. Method Data from baseline and postnatal questionnaires (3, 6, 12 and 18 months) were analysed using univariable and multivariable logistic regression. Main outcome measure Study-designed self-report measure of dyspareunia at 18 months postpartum. Results In all, 1244/1507 (83%) women completed the baseline and all four postpartum questionnaires; 1211/1237 (98%) had resumed vaginal intercourse by 18 months postpartum, with 289/1211 (24%) women reporting dyspareunia. Compared with women who had a spontaneous vaginal delivery with an intact perineum or unsutured tear, women who had an emergency caesarean section (adjusted odds ratio [aOR] 2.41, 95% confidence interval [95% CI] 1.4-4.0; P = 0.001), vacuum extraction (aOR 2.28, 95% CI 1.3-4.1; P = 0.005) or elective caesarean section (aOR 1.71, 95% CI 0.9-3.2; P = 0.087) had increased odds of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other potential confounders. Conclusions Obstetric intervention is associated with persisting dyspareunia. Greater recognition and increased understanding of the roles of mode of delivery and perineal trauma in contributing to postpartum maternal morbidities, and ways to prevent postpartum dyspareunia where possible, are warranted.

LanguageEnglish
Pages672-679
Number of pages8
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume122
Issue number5
DOIs
Publication statusPublished - 1 Apr 2015

Keywords

  • Cohort studies
  • delivery obstetric
  • dyspareunia
  • pain
  • perineum
  • postpartum period
  • prospective studies
  • sexual intercourse

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

McDonald, E. A. ; Gartland, D. ; Small, Rhonda ; Brown, Stephanie. / Dyspareunia and childbirth : A prospective cohort study. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2015 ; Vol. 122, No. 5. pp. 672-679.
@article{da4b1273807c46809a18b299718e3e0b,
title = "Dyspareunia and childbirth: A prospective cohort study",
abstract = "Objective To investigate the relationship between mode of delivery, perineal trauma and dyspareunia. Design Prospective cohort study. Setting Six maternity hospitals in Melbourne, Australia. Sample A total of 1507 nulliparous women recruited in the first and second trimesters of pregnancy. Method Data from baseline and postnatal questionnaires (3, 6, 12 and 18 months) were analysed using univariable and multivariable logistic regression. Main outcome measure Study-designed self-report measure of dyspareunia at 18 months postpartum. Results In all, 1244/1507 (83{\%}) women completed the baseline and all four postpartum questionnaires; 1211/1237 (98{\%}) had resumed vaginal intercourse by 18 months postpartum, with 289/1211 (24{\%}) women reporting dyspareunia. Compared with women who had a spontaneous vaginal delivery with an intact perineum or unsutured tear, women who had an emergency caesarean section (adjusted odds ratio [aOR] 2.41, 95{\%} confidence interval [95{\%} CI] 1.4-4.0; P = 0.001), vacuum extraction (aOR 2.28, 95{\%} CI 1.3-4.1; P = 0.005) or elective caesarean section (aOR 1.71, 95{\%} CI 0.9-3.2; P = 0.087) had increased odds of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other potential confounders. Conclusions Obstetric intervention is associated with persisting dyspareunia. Greater recognition and increased understanding of the roles of mode of delivery and perineal trauma in contributing to postpartum maternal morbidities, and ways to prevent postpartum dyspareunia where possible, are warranted.",
keywords = "Cohort studies, delivery obstetric, dyspareunia, pain, perineum, postpartum period, prospective studies, sexual intercourse",
author = "McDonald, {E. A.} and D. Gartland and Rhonda Small and Stephanie Brown",
year = "2015",
month = "4",
day = "1",
doi = "10.1111/1471-0528.13263",
language = "English",
volume = "122",
pages = "672--679",
journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "Wiley-Blackwell",
number = "5",

}

Dyspareunia and childbirth : A prospective cohort study. / McDonald, E. A.; Gartland, D.; Small, Rhonda; Brown, Stephanie.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 122, No. 5, 01.04.2015, p. 672-679.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dyspareunia and childbirth

T2 - BJOG: An International Journal of Obstetrics and Gynaecology

AU - McDonald, E. A.

AU - Gartland, D.

AU - Small, Rhonda

AU - Brown, Stephanie

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Objective To investigate the relationship between mode of delivery, perineal trauma and dyspareunia. Design Prospective cohort study. Setting Six maternity hospitals in Melbourne, Australia. Sample A total of 1507 nulliparous women recruited in the first and second trimesters of pregnancy. Method Data from baseline and postnatal questionnaires (3, 6, 12 and 18 months) were analysed using univariable and multivariable logistic regression. Main outcome measure Study-designed self-report measure of dyspareunia at 18 months postpartum. Results In all, 1244/1507 (83%) women completed the baseline and all four postpartum questionnaires; 1211/1237 (98%) had resumed vaginal intercourse by 18 months postpartum, with 289/1211 (24%) women reporting dyspareunia. Compared with women who had a spontaneous vaginal delivery with an intact perineum or unsutured tear, women who had an emergency caesarean section (adjusted odds ratio [aOR] 2.41, 95% confidence interval [95% CI] 1.4-4.0; P = 0.001), vacuum extraction (aOR 2.28, 95% CI 1.3-4.1; P = 0.005) or elective caesarean section (aOR 1.71, 95% CI 0.9-3.2; P = 0.087) had increased odds of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other potential confounders. Conclusions Obstetric intervention is associated with persisting dyspareunia. Greater recognition and increased understanding of the roles of mode of delivery and perineal trauma in contributing to postpartum maternal morbidities, and ways to prevent postpartum dyspareunia where possible, are warranted.

AB - Objective To investigate the relationship between mode of delivery, perineal trauma and dyspareunia. Design Prospective cohort study. Setting Six maternity hospitals in Melbourne, Australia. Sample A total of 1507 nulliparous women recruited in the first and second trimesters of pregnancy. Method Data from baseline and postnatal questionnaires (3, 6, 12 and 18 months) were analysed using univariable and multivariable logistic regression. Main outcome measure Study-designed self-report measure of dyspareunia at 18 months postpartum. Results In all, 1244/1507 (83%) women completed the baseline and all four postpartum questionnaires; 1211/1237 (98%) had resumed vaginal intercourse by 18 months postpartum, with 289/1211 (24%) women reporting dyspareunia. Compared with women who had a spontaneous vaginal delivery with an intact perineum or unsutured tear, women who had an emergency caesarean section (adjusted odds ratio [aOR] 2.41, 95% confidence interval [95% CI] 1.4-4.0; P = 0.001), vacuum extraction (aOR 2.28, 95% CI 1.3-4.1; P = 0.005) or elective caesarean section (aOR 1.71, 95% CI 0.9-3.2; P = 0.087) had increased odds of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other potential confounders. Conclusions Obstetric intervention is associated with persisting dyspareunia. Greater recognition and increased understanding of the roles of mode of delivery and perineal trauma in contributing to postpartum maternal morbidities, and ways to prevent postpartum dyspareunia where possible, are warranted.

KW - Cohort studies

KW - delivery obstetric

KW - dyspareunia

KW - pain

KW - perineum

KW - postpartum period

KW - prospective studies

KW - sexual intercourse

UR - http://www.scopus.com/inward/record.url?scp=84925243389&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.13263

DO - 10.1111/1471-0528.13263

M3 - Article

VL - 122

SP - 672

EP - 679

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 5

ER -