title: Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study.
abstract: OBJECTIVE
  To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy.
  
  
  METHODS
  Retrospective, population-based register study.
  
  
  METHODS
  Sweden.
  
  
  METHODS
  All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09.
  
  
  METHODS
  Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression.
  
  
  METHODS
  Parity and mode of delivery.
  
  
  RESULTS
  Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P < 0.001), a lower body mass index (P < 0.001) and use nicotine during pregnancy (P = 0.008). They were less likely to give birth (adjusted odds ratio [OR] 0.61, 95% confidence interval [95% CI] 0.56-0.67). Women with vaginismus/LPV more often delivered by caesarean section (P < 0.001) especially for maternal request (adjusted OR 3.48, 95% CI 2.45-4.39). In women having vaginal delivery, those with vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25).
  
  
  CONCLUSIONS
  Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Möller
authors.forename: A
authors.initials: A
authors.lastname: Josefsson
authors.forename: M
authors.initials: M
authors.lastname: Bladh
authors.forename: C
authors.initials: C
authors.lastname: Lilliecreutz
authors.forename: G
authors.initials: G
authors.lastname: Sydsjö
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004414:Dyspareunia / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D017533:Marital Status; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016017:Odds Ratio; D010298:Parity; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012042:Registries; D012189:Retrospective Studies; D012923:Social Class; D013548:Sweden / Q000453:epidemiology; D052065:Vaginismus / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D056650:Vulvodynia / Q000150:complications / Q000453:epidemiology* / Q000523:psychology
keywords: Caesarean section; localised provoked vestibulodynia; reproduction; vaginismus