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Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum

To identify distinct trajectories of dyspareunia in primiparous women and examine biopsychosocial risk factors of these trajectories. METHODS: This was a prospective cohort of 582 first-time mothers. Participants completed validated measures of dyspareunia at 20–24 (baseline) and 32–36 weeks of gest...

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Autores principales: Rosen, Natalie O., Dawson, Samantha J., Binik, Yitzchak M., Pierce, Marianne, Brooks, Melissa, Pukall, Caroline, Chorney, Jill, Snelgrove-Clarke, Erna, George, Ronald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843395/
https://www.ncbi.nlm.nih.gov/pubmed/35115480
http://dx.doi.org/10.1097/AOG.0000000000004662
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author Rosen, Natalie O.
Dawson, Samantha J.
Binik, Yitzchak M.
Pierce, Marianne
Brooks, Melissa
Pukall, Caroline
Chorney, Jill
Snelgrove-Clarke, Erna
George, Ronald
author_facet Rosen, Natalie O.
Dawson, Samantha J.
Binik, Yitzchak M.
Pierce, Marianne
Brooks, Melissa
Pukall, Caroline
Chorney, Jill
Snelgrove-Clarke, Erna
George, Ronald
author_sort Rosen, Natalie O.
collection PubMed
description To identify distinct trajectories of dyspareunia in primiparous women and examine biopsychosocial risk factors of these trajectories. METHODS: This was a prospective cohort of 582 first-time mothers. Participants completed validated measures of dyspareunia at 20–24 (baseline) and 32–36 weeks of gestation and at 3, 6, 12, and 24 months postpartum. Risk factors were assessed at baseline and 3 months postpartum, with labor and delivery characteristics collected by medical record review. Latent class growth analysis was conducted to identify homogeneous subgroups with distinct trajectories of dyspareunia. Univariable and multivariable binomial logistic regressions examined whether predictors were associated with these trajectories. RESULTS: Overall, the prevalence of dyspareunia ranged from 31.4% at 3 months postpartum to 11.9% at 24 months. We identified two distinct classes of dyspareunia with 21% of women in the class with moderate dyspareunia and 79% in the class with minimal dyspareunia, with pain decreasing in both groups until 12 months postpartum and little change thereafter. Biomedical factors—prior chronic pain (including preexisting dyspareunia), labor epidural analgesia, induction, episiotomy, perineal laceration, mode of delivery, breastfeeding, and whether the woman had a new pregnancy during the postpartum period—did not significantly predict dyspareunia class. Greater fatigue (odds ratio [OR] 1.30; 95% CI 1.05–1.60) and depressive symptoms (OR 1.08; 95% CI 1.02–1.14) in pregnancy and fatigue (OR 1.27; 95% CI 1.04–1.56) and pain catastrophizing (OR 1.10; 95% CI 1.05–1.16) at 3 months postpartum increased the odds for the moderate relative to the minimal pain trajectory in univariable models. In a multivariable model, pain catastrophizing at 3 months postpartum (OR 1.09; 95% CI 1.04–1.15) was associated with the moderate relative to the minimal pain trajectory. CONCLUSION: We identified two distinct trajectories of dyspareunia across pregnancy and postpartum. One in five nulliparous women experienced moderate dyspareunia. Pain catastrophizing at 3 months postpartum was associated with experiencing moderate relative to minimal levels of dyspareunia.
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spelling pubmed-88433952022-02-17 Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum Rosen, Natalie O. Dawson, Samantha J. Binik, Yitzchak M. Pierce, Marianne Brooks, Melissa Pukall, Caroline Chorney, Jill Snelgrove-Clarke, Erna George, Ronald Obstet Gynecol Contents To identify distinct trajectories of dyspareunia in primiparous women and examine biopsychosocial risk factors of these trajectories. METHODS: This was a prospective cohort of 582 first-time mothers. Participants completed validated measures of dyspareunia at 20–24 (baseline) and 32–36 weeks of gestation and at 3, 6, 12, and 24 months postpartum. Risk factors were assessed at baseline and 3 months postpartum, with labor and delivery characteristics collected by medical record review. Latent class growth analysis was conducted to identify homogeneous subgroups with distinct trajectories of dyspareunia. Univariable and multivariable binomial logistic regressions examined whether predictors were associated with these trajectories. RESULTS: Overall, the prevalence of dyspareunia ranged from 31.4% at 3 months postpartum to 11.9% at 24 months. We identified two distinct classes of dyspareunia with 21% of women in the class with moderate dyspareunia and 79% in the class with minimal dyspareunia, with pain decreasing in both groups until 12 months postpartum and little change thereafter. Biomedical factors—prior chronic pain (including preexisting dyspareunia), labor epidural analgesia, induction, episiotomy, perineal laceration, mode of delivery, breastfeeding, and whether the woman had a new pregnancy during the postpartum period—did not significantly predict dyspareunia class. Greater fatigue (odds ratio [OR] 1.30; 95% CI 1.05–1.60) and depressive symptoms (OR 1.08; 95% CI 1.02–1.14) in pregnancy and fatigue (OR 1.27; 95% CI 1.04–1.56) and pain catastrophizing (OR 1.10; 95% CI 1.05–1.16) at 3 months postpartum increased the odds for the moderate relative to the minimal pain trajectory in univariable models. In a multivariable model, pain catastrophizing at 3 months postpartum (OR 1.09; 95% CI 1.04–1.15) was associated with the moderate relative to the minimal pain trajectory. CONCLUSION: We identified two distinct trajectories of dyspareunia across pregnancy and postpartum. One in five nulliparous women experienced moderate dyspareunia. Pain catastrophizing at 3 months postpartum was associated with experiencing moderate relative to minimal levels of dyspareunia. Lippincott Williams & Wilkins 2022-03 2022-02-02 /pmc/articles/PMC8843395/ /pubmed/35115480 http://dx.doi.org/10.1097/AOG.0000000000004662 Text en © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Contents
Rosen, Natalie O.
Dawson, Samantha J.
Binik, Yitzchak M.
Pierce, Marianne
Brooks, Melissa
Pukall, Caroline
Chorney, Jill
Snelgrove-Clarke, Erna
George, Ronald
Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title_full Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title_fullStr Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title_full_unstemmed Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title_short Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum
title_sort trajectories of dyspareunia from pregnancy to 24 months postpartum
topic Contents
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843395/
https://www.ncbi.nlm.nih.gov/pubmed/35115480
http://dx.doi.org/10.1097/AOG.0000000000004662
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