Women's sexual health six months after a severe maternal morbidity event.

OBJECTIVE: to investigate female sexual function in women six months postpartum and to compare sexual function among women who had and who did not have severe maternal morbidity (SMM). METHOD: a cross-sectional study conducted with 110 women in the postpartum period, with and without SMM. Two instruments were used, one for the characterization of sociodemographic and obstetric variables and the Female Sexual Function Index (FSFI) for sexual function. Univariate, bivariate and regression model analyses were performed. RESULTS: FSFI scores showed 44.5% of female sexual dysfunction, of which 48.7% were among women who had SMM and 42.0% among those who had not. There were significant differences between age (P=0.013) and duration of pregnancy (P<0.001) between women with or without SMM. Among the cases of SMM, hypertensive disorders were the most frequent (83%). An association was obtained between some domains of the FSFI and the following variables: orgasm and self-reported skin color, satisfaction and length of relationship, and pain and SMM. CONCLUSION: white women have greater difficulty in reaching orgasm when compared to non-white women and women with more than 120 months of relationship feel more dissatisfied with sexual health than women with less time in a relationship. Women who have had some type of SMM have more dyspareunia when compared to women who have not had SMM.

Women's sexual health six months after a severe maternal morbidity event / Saúde sexual de mulheres seis meses após um evento de morbidade materna grave / Salud sexual de mujeres seis meses después de un evento de morbilidad materna extrema

Objective: to investigate female sexual function in women six months postpartum and to compare sexual function among women who had and who did not have severe maternal morbidity (SMM). Method: a cross-sectional study conducted with 110 women in the postpartum period, with and without SMM. Two instruments were used, one for the characterization of sociodemographic and obstetric variables and the Female Sexual Function Index (FSFI) for sexual function. Univariate, bivariate and regression model analyses were performed. Results: FSFI scores showed 44.5% of female sexual dysfunction, of which 48.7% were among women who had SMM and 42.0% among those who had not. There were significant differences between age (P=0.013) and duration of pregnancy (P<0.001) between women with or without SMM. Among the cases of SMM, hypertensive disorders were the most frequent (83%). An association was obtained between some domains of the FSFI and the following variables: orgasm and self-reported skin color, satisfaction and length of relationship, and pain and SMM. Conclusion: white women have greater difficulty in reaching orgasm when compared to non-white women and women with more than 120 months of relationship feel more dissatisfied with sexual health than women with less time in a relationship. Women who have had some type of SMM have more dyspareunia when compared to women who have not had SMM.

Objetivo: investigar a função sexual feminina em mulheres seis meses pós-parto e comparar a função sexual entre mulheres que tiveram e que não tiveram morbidade materna grave (MMG). Método: estudo transversal, com 110 mulheres no período pós-parto, com e sem MMG. Foram utilizados dois instrumentos, um para caracterização das variáveis sociodemográficas e obstétricas e o Female Sexual Function Index (FSFI) para a função sexual. Foram realizadas análises univariada, bivariada e modelo de regressão. Resultados: os escores do FSFI mostraram 44,5% de disfunção sexual feminina, sendo 48,7% entre as mulheres que tiveram MMG e 42,0% entre as que não tiveram. Houve diferenças significativas entre idade (P=0,013) e duração da gravidez (P<0,001) entre as mulheres com ou sem MMG. Dentre os casos de MMG, os distúrbios hipertensivos foram os mais frequentes (83%). Obteve-se associação entre alguns domínios do FSFI e as variáveis: orgasmo e cor autorreferida, satisfação e tempo de relacionamento, e dor e MMG. Conclusão: mulheres brancas têm maior dificuldade de atingir orgasmo quando comparadas com mulheres não-brancas e mulheres com mais de 120 meses de relacionamento sentem-se mais insatisfeitas com a saúde sexual do que mulheres com menor tempo de relacionamento. Mulheres que tiveram algum tipo de MMG apresentam mais dispareunia quando comparadas com mulheres que não tiveram MMG.

Objetivo: investigar la función sexual femenina en las mujeres seis meses después del parto y comparar la función sexual entre las mujeres que tenían y que no tenían morbilidad materna extrema (MME). Método: estudio transversal con 110 mujeres en el posparto, con y sin MME. Se utilizaron dos instrumentos, uno para la caracterización de variables sociodemográficas y obstétricas y el Índice de Female Sexual Function Index (FSFI) para la función sexual. Se realizaron análisis de modelos univariados, bivariados y modelo de regresión. Resultados: los puntajes del FSFI mostraron el 44.5% de la disfunción sexual femenina, de los cuales el 48.7% correspondió a mujeres que tenían MME y el 42% a las que no. Hubo diferencias significativas entre la edad (P = 0.013) y la duración del embarazo (P <0.001) entre mujeres con o sin MME. Entre los casos de MME, los trastornos hipertensivos fueron los más frecuentes (83%). Se obtuvo una asociación entre algunos dominios del FSFI y las variables: orgasmo y color autoinformado, satisfacción y duración de la relación, y dolor y MME. Conclusión: las mujeres blancas tienen mayor dificultad para alcanzar el orgasmo si se las compara con las mujeres no blancas y las mujeres con más de 120 meses de relación se sienten más insatisfechas con la salud sexual que las mujeres con menos tiempo de relación. Las mujeres que han tenido algún tipo de MME tienen más dispareunia en comparación con las mujeres que no han tenido MME.

[Under the shadow of maternity: pregnancy, suicidal ideation, and intimate partner violence]. / Sob a sombra da maternidade: gravidez, ideação suicida e violência por parceiro íntimo.

OBJECTIVE: To investigate the association between intimate partner violence and indicators of suicidal ideation during the current pregnancy. METHODS: This is a cross-sectional observational study developed with 358 pregnant women selected by systematic random sampling in Ribeirão Preto, southeastern Brazil. The Back Suicidal Ideation Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to identify indicators of suicidal ideation and psychological, physical, and sexual acts of intimate partner violence during the current pregnancy. Multiple logistic regression was used to obtain adjusted prevalence odds ratios with a 95% confidence interval. RESULTS: The prevalence of indicators of suicidal ideation was 7.8%. Of the participants, 17.6% reported some type of intimate partner violence during the current pregnancy. Among these, 95.2% reported having suffered psychological violence, 36.5% physical violence, and 1.6% sexual violence. Multiple logistic regression analysis showed that women exposed to violence were 6.29 times more likely to have indicators of suicidal ideation. CONCLUSIONS: Policy makers and health care providers must be made aware of the impact of intimate partner violence, including in terms of suicidal ideation, especially during pregnancy. The adoption of simple measures, such as the scales used in the present study, may provide information regarding the extent of intimate partner violence and suicidal ideation in health care services.