Sexual dysfunction predicts depressive symptoms during the first 2 years postpartum

Background: The association between sexual function and depression has yet to be examined in a prospective cohort study with prolonged postpartum follow-up. Aim: We investigated whether sexual dysfunction predicted depressive symptoms during the 24-month postpartum period and examined the influence of obstetric factors. Methods: This prospective 2-year cohort study with repeated measures included 196 participants who were recruited in a medical center in Taipei, Taiwan (2010-2011). Data on participants' personal characteristics, sexual function, and depression symptoms at 4-6 weeks and at 3, 6, 12, and 24 months postpartum were collected and then assessed using the Female Sexual Function Index and the Center for Epidemiologic Studies Depression Scale. Results: After adjusting for time and covariates, women with sexual dysfunction had a 1.62-fold (95% confidence interval [CI]: 1.05-2.50-fold) higher estimated odds ratio (OR) for depressive symptoms during the entire 24 months after childbirth than did women without sexual dysfunction. Risk factors for depressive symptoms were a higher pain score (OR: 1.33, 95% CI: 1.13-1.57), a medical condition (OR: 1.65, 95% CI: 1.00-2.73), and severe perineal laceration (OR: 4.67, 95% CI: 1.37-15.92). Sexual satisfaction during the entire 24 months after childbirth (OR: 0.81, 95% CI: 0.70-0.95) and the highest personal income level (OR: 0.33, 95% CI: 0.11-0.99) were factors protecting against higher-scoring depressive symptoms. Conclusions: Our study provides robust evidence that sexual dysfunction and poor satisfaction, together with severe perineal laceration, greater pain, and a medical condition, predict depressive symptoms during the 24-month postpartum period. (c) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.