اختلال عملکرد جنسی پس از زایمان در زنان ایرانی و عوامل مرتبط با آن: مرور سیستماتیک و متاآنالیز

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، کمیته‌ی پژوهشی دانشجویان، گروه مامایی و بهداشت باروری، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 گروه مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 متخصص زنان و زایمان، دانشگاه علوم پزشکی البرز، کرج، ایران

4 دانشیار، گروه مامایی و بهداشت باروری، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقدمه: اختلال عملکرد جنسی زنان در دوران پس از زایمان، یکی از مشکلات مهم سلامتی زنان در دوران پس از زایمان می‌باشد. این مطالعه، با هدف تعیین اختلال عملکرد جنسی در دوره‌ی پس از زایمان و عوامل مرتبط با آن در زنان ایرانی انجام شد.روش‌ها: در این مطالعه‌ی مرور سیستماتیک و متاآنالیز، مقالات ایرانی منتشر شده در پایگاه‌های PubMed،Scopus، Web of science، ProQuest، Magiran، Scientific Information Database (SID)، IranMedex و IranDoc با استفاده از کلید واژه‌های مرتبط با «عملکرد جنسی پس از زایمان» مورد جستجو قرار گرفتند. معیار ورود شامل مطالعات مشاهده‌ای (بین سال‌های 2019-1990) بود که ابزارهای استاندارد جهت سنجش عملکرد جنسی استفاده کرده بودند. جهت بررسی احتمال سوگیری در انتشار نتایج، از آزمون آماری Egger's استفاده شد. واکاوی داده‌ها، با استفاده از نرم‌افزار STATA 14 انجام شد.یافته‌ها: در این مطالعه، تعداد 12 مقاله بعد از انجام کیفیت‌سنجی با ابزار Newcastle–Ottawa، مورد واکاوی قرار گرفتند. میانگین کلی نمره‌ی عملکرد جنسی پس از انجام واکاوی حساسیت،30/22 (80/22-80/21) و در بعد میل جنسی 52/3 (84/3-20/3)، کمترین نمره و در بعد رضایت جنسی 28/4 (40/4-03/4) بود. عوامل مرتبط با عملکرد جنسی شامل عوامل فردی و دموگرافیک، عوامل پزشکی و عوامل عاطفی و روانی بودند.نتیجه‌گیری: عملکرد جنسی پس از زایمان در زنان ایرانی تحت تأثیر عوامل متعددی می‌باشد. از این رو، توصیه می‌شود در مشاوره‌های پس از زایمان، به بعد جنسی زندگی زنان توجه شود و جهت اقدامات مداخله‌ای در این زمینه برنامه‌ریزی شود.

کلیدواژه‌ها

عنوان مقاله [English]

Postpartum Female Sexual Dysfunction and Related Factors in Iranian Women: A Systematic Review and Meta-analysis

نویسندگان [English]

  • Marzieh Saei-Gharenaz 1
  • Mojdeh Banaei 1
  • Vida Ghasemi 1
  • Farzaneh Rashidi-Fakari 1
  • Azam Khiabani 2
  • Masumeh Abed 3
  • Giti Ozgoli 4
1 PhD Candidate of Reproductive Health, Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Obstetrician and Gynecologist, Alborz University of Medical Sciences, Karaj, Iran
4 Associate Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background: Female sexual dysfunction in the postpartum period is one of the major health problems of women. The aim of this study was to determine the postpartum sexual dysfunction and its related factors in Iranian women.Methods: In this systematic review and meta-analysis study, Iranian articles published at PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database (SID), IranMedex, IranDoc were searched by keywords related to "postpartum sexual function". The inclusion criteria were as the studies, which used standard tools to measure sexual function, and included observational studies (from 1990 to 2019). Egger statistical test was used to investigate the probability of bias in the publication bias. Data were analyzed using STATA 14 software.Findings: Finally, after quality assessment by Newcastle Ottawa instrument, 12 articles were analyzed. The overall mean score of sexual function after sensitivity analysis was 22.30 [95% confidence interval (CI): 21.8-22.8], the lowest score was in the sexual desire dimension as 3.52 (95% CI, 3.2-20-3.84), and in the sexual satisfaction dimension, it was 4.28 (5 95% CI: 4.4-4.03). Factors related to sexual function included individual and demographic factors, medical factors, and emotional and psychological factors.Conclusion: The postpartum sexual function in Iranian women is influenced by several factors; so it is recommended to pay attention to the sexual dimension of women's postpartum counseling, and to plan interventional measures in this regard.

کلیدواژه‌ها [English]

  • Sexual dysfunctions, Physiological
  • Women
  • Obstetric delivery
  • Meta-Analysis

مراجع

  1. Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, et al. Report of the international consensus development conference on female sexual dysfunction: Definitions and classifications. J Urol 2000; 163(3): 888-93.
  2. Latif EZ, Diamond MP. Arriving at the diagnosis of female sexual dysfunction. Fertil Steril 2013; 100(4): 898-904.
  3. Sayasneh A, Pandeva I. Postpartum sexual disfunction. A literature review of risk factors and role of mode of delivery. British Journal of Medical Practitioners 2010; 3(2): 316-20.
  4. Hanafy S, Elesawy F. Female sexual dysfunction during the postpartum period. Human Andrology 2015; 5(4): 71-81.
  5. McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C. Predictors of female sexual dysfunction: A systematic review and qualitative analysis through gender inequality paradigms. BMC Womens Health 2018; 18(1): 108.
  6. West SL, Vinikoor LC, Zolnoun D. A systematic review of the literature on female sexual dysfunction prevalence and predictors. Annu Rev Sex Res 2004; 15: 40-172.
  7. Darooneh T, Sheikhan Z, Saei-Gharenaz M, Jalali-Chimeh F, Kholosi F, Nasiri M, et al. The prognostic factors of sexual dysfunction among selected pregnant women in Tehran City, Iran. J Isfahan Med Sch 2019; 37(522): 328-34. [In Persian].
  8. McBride HL, Kwee JL. Sex after baby: Women’s sexual function in the postpartum period. Curr Sex Health Rep 2017; 9(3): 142-9.
  9. Ozgoli G, Dolatian M, Sheykhan Z, Valaei N. Study of sexual function and satisfaction in women with vaginal delivery and cesarean referring to Health Center of Shahid Beheshti Medical University-2008. Pajoohande 2011; 15(6): 257-63. [In Persian].
  10. Mivsek AP. Sexology in midwifery. Zaksek TS, editor. Sexual activity during pregnancy in childbirth and after childbirth. IntechOpen; 2015.
  11. Abdool Z, Thakar R, Sultan AH. Postpartum female sexual function. Eur J Obstet Gynecol Reprod Biol 2009; 145(2): 133-7.
  12. Holanda JBL, Abuchaim ESV, Coca KP, Abrao ACFV. Sexual dysfunction and associated factors reported in the postpartum period. Acta Paul Enferm 2014; 27(6): 573-8.
  13. Khajehei M, Doherty M, Tilley PJ, Sauer K. Prevalence and risk factors of sexual dysfunction in postpartum Australian women. J Sex Med 2015; 12(6): 1415-26.
  14. Alp Yilmaz F, Avci D, Arzu AY, Ozdilek R, Dutucu N. Sexual dysfunction in postpartum Turkish women: It's relationship with depression and some risk factors. Afr J Reprod Health 2018; 22(4): 54-63.
  15. Fuentealba-Torres M, Cartagena-Ramos D, Fronteira I, Lara LA, Arroyo LH, Arcoverde MAM, et al. What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open 2019; 9(4): e025833.
  16. Albanese S, Taavoni S, Ahmadi HZ, Hosseini F. Sexual changes and related sexual factors in primipara mothers during 3 to 6 months postpartum 1384. Iran J Nurs 2005; 18(41-42): 69-76. [In Persian].
  17. Damari B, Tabrizchi N, Riazi-Isfahan S. Designing a national plan for improving sexual health in Iran: An experience of an Islamic country. Med J Islam Repub Iran 2016; 30: 407.
  18. Khani S, Moghaddam-Banaem L, Mohamadi E, Vedadhir AA, Hajizadeh E. Women's sexual and reproductive health care needs assessment: An Iranian perspective. East Mediterr Health J 2018; 24(7): 637-43.
  19. WHO, United Nations Population Fund, UNICEF. Pregnancy, childbirth, postpartum and newborn care A guide for essential practice. 3rd ed. Geneva, Switzerland; World Health Organization; 2015.
  20. Moller AM, Myles PS. What makes a good systematic review and meta-analysis? Br J Anaesth 2016; 117(4): 428-30.
  21. Johnson BT, Hennessy EA. Systematic reviews and meta-analyses in the health sciences: Best practice methods for research syntheses. Soc Sci Med 2019; 233: 237-51.
  22. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4: 1.
  23. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097.
  24. Wells G, Shea B, O'Connell D, Peterson j, Welch V, Losos M, et al. The Newcastle Ottawa Scale (NOS) for Assessing the Quality of Non-Randomized Studies in Meta-Analysis. Ottawa, Canada: The Ottawa Hospital Research Institute; 2014.
  25. Modesti PA, Reboldi G, Cappuccio FP, Agyemang C, Remuzzi G, Rapi S, et al. Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLoS One 2016; 11(1): e0147601.
  26. Wells G. Shea. B., O'Connell. D., Peterson J, Welch V, Losos M, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa, Canada: The Ottawa Hospital Research Institute; 2011.
  27. Behboodi MZ, Rezaei E, Khaleghi YF, Montazeri A, Arzaqi SM, Tavakol Z, et al. The effect of sexual health education program on women sexual function in Iran. J Res Health Sci 2015; 15(2): 124-8.
  28. Fakhri A, Pakpour AH, Burri A, Morshedi H, Zeidi IM. The Female Sexual Function Index: Translation and validation of an Iranian version. J Sex Med 2012; 9(2): 514-23.
  29. Mohammadi K, Heydari M, Faghihzadeh S. The Female Sexual Function Index (FSFI): Validation of the Iranian version. Payesh 2008; 7(3): 269-78. [In Persian].
  30. Raisi F. Arizona Sexual Experience Scale (ASEX): Persian translation and cultural adaptation: 851. J Sex Med 2011; 8(Suppl 3): 296-7.
  31. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557-60.
  32. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Chichester, UK: John Wiley and Sons; 2011.
  33. Egger M, Davey SG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629-34.
  34. Mahmodiyan A, Kazemi S, Ghojazade M. Comparison of Sexual problems during the first 6 month after normal vaginal delivery and cesarean in nulliparous women referred to health centers of Ramsar in 2014-2015. Iran J Obstet Gynecol Infertil 2017; 20(5): 7-14. [In Persian].
  35. Amiri FN, Omidvar S, Bakhtiari A, Hajiahmadi M. Female sexual outcomes in primiparous women after vaginal delivery and cesarean section. Afr Health Sci 2017; 17(3): 623-31.
  36. Ahmad Shirvani M, Bagheri Nesami M. Sexual dysfunction and related factors among breast feeding women. Iran J Obstet Gynecol Infertil 2011; 14(5): 36-42. [In Persian].
  37. Broumandfar K, Farajzadegan Z, Hoseini H, Ghaed Rahmati M. Reviewing sexual function after delivery and its association with some of the demographic marital satisfaction factors. Alborz Univ Med J. 2012; 1(2): 93-9. [In Persian].
  38. Banaei M, Moridi A, Dashti S. Sexual dysfunction and its associated factors after delivery: Longitudinal study in Iranian women. Mater Sociomed 2018; 30(3): 198-203.
  39. Rezaei N, Azadi A, Sayehmiri K, Valizadeh R. Postpartum sexual functioning and its predicting factors among Iranian Women. malays J Med Sci 2017; 24(1): 94-103.
  40. Anbaran ZK, Baghdari N, Pourshirazi M, Karimi FZ, Rezvanifard M, Mazlom SR. Postpartum sexual function in women and infant feeding methods. J Pak Med Assoc 2015; 65(3): 248-52.
  41. Karimi F, Babazadeh R, Latifnejad-Roudsari R, Esmaily H. The relationship between sexual function and sexual self-disclosure in women after childbirth. J Isfahan Med Sch 2018; 36(502): 1321-8. [In Persian].
  42. Moghimi Hanjani S, Mehdizadeh Tourzani Z. Comparison of sexual function after childbirth in primiparous women experiencing vaginal delivery and caesarian section in Karaj city. Q Horizon Med Sc 2013; 18(5 Suppl): 224-31. [In Persian].
  43. Haghdoost A, Sadeghirad B. Systematic review and meta analysis. Tehran, Iran: Gap Publications; 2014. [In Persian].
  44. Akhavan-Akbari P, Ozgoli G, Simbar M, Besharat M. Nonbiological predictors of sexual desire in women with female sexual interest and arousal disorder. J Isfahan Med Sch 2018; 36(470): 201-8. [In Persian].
  45. Acele EO, Karacam Z. Sexual problems in women during the first postpartum year and related conditions. J Clin Nurs 2012; 21(7-8): 929-37.
  46. Rupp HA, James TW, Ketterson ED, Sengelaub DR, Ditzen B, Heiman JR. Lower sexual interest in postpartum women: Relationship to amygdala activation and intranasal oxytocin. Horm Behav 2013; 63(1): 114-21.
  47. Johnson CE. Sexual health during pregnancy and the postpartum. J Sex Med 2011; 8(5): 1267-84.
  48. Leeman LM, Rogers RG. Sex after childbirth: postpartum sexual function. Obstet Gynecol 2012; 119(3): 647-55.
  49. Wallwiener S, Muller M, Doster A, Kuon RJ, Plewniok K, Feller S, et al. Sexual activity and sexual dysfunction of women in the perinatal period: A longitudinal study. Arch Gynecol Obstet 2017; 295(4): 873-83.
  50. Jawed-Wessel S, Sevick E. The impact of pregnancy and childbirth on sexual behaviors: A systematic review. J Sex Res 2017; 54(4-5): 411-23.
  51. Dean N, Wilson D, Herbison P, Glazener C, Aung T, Macarthur C. Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: A cross-sectional study six years post-partum. Aust N Z J Obstet Gynaecol 2008; 48(3): 302-11.
  52. Hosseini L, Iran-Pour E, Safarinejad MR. Sexual function of primiparous women after elective cesarean section and normal vaginal delivery. Urol J 2012; 9(2): 498-504.
  53. Barbara G, Pifarotti P, Facchin F, Cortinovis I, Dridi D, Ronchetti C, et al. Impact of mode of delivery on female postpartum sexual functioning: Spontaneous vaginal delivery and operative vaginal delivery vs. cesarean section. J Sex Med 2016; 13(3): 393-401.
  54. Moghasemi S, Ozgoli G, Ahmadi F, Simbar M. Sexual health care utilization in married middle aged women; a cross-sectional study. J Isfahan Med Sch 2018; 35(455): 1640-7. [In Persian].
  55. Darooneh T, Ozgoli G, Sheikhan Z, Nasiri M. A study on the relationship of economic and demographic factors with sexual and marital satisfaction in a sample of Iranian women, 2015-2016. J Isfahan Med Sch 2017; 35(418): 50-6. [In Persian].
  56. Malakoti J, Zamanzadeh V, Maleki A, Farshbaf KA. Sexual function in breastfeeding women in family health centers of Tabriz, Iran, 2012. J Caring Sci 2013; 2(2): 141-6.
  57. Dabiri F, Yabandeh AP, Shahi A, Kamjoo A, Teshnizi SH. The effect of mode of delivery on postpartum sexual functioning in primiparous women. Oman Med J 2014; 29(4): 276-9.
  58. Ghorat F, Esfehani RJ, Sharifzadeh M, Tabarraei Y, Aghahosseini SS. Long term effect of vaginal delivery and cesarean section on female sexual function in primipara mothers. Electron Physician 2017; 9(3): 3991-6.
مجله دانشکده پزشکی اصفهان
دوره 37، شماره 546 - شماره پیاپی 546
آذر و دی 1398
صفحه 1149-1161

فایل ها

سابقه مقاله

  • تاریخ دریافت: 22 مهر 1398
  • تاریخ بازنگری: 07 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

هم رسانی

ارجاع به این مقاله

آمار