title: Sexual Problems During Pregnancy and After Delivery Among Women With and Without Anxiety and Depressive Disorders Prior to Pregnancy: A Prospective-Longitudinal Study.
abstract: BACKGROUND
  Few prospective-longitudinal studies have examined the course of sexual problems during pregnancy and after delivery in women with and without anxiety and depressive disorders prior to pregnancy as well as with and without maternal birth injuries.
  
  
  OBJECTIVE
  To prospectively investigate associations of anxiety and depressive disorders prior to pregnancy and maternal birth injuries with sexual problems during the peripartum period.
  
  
  METHODS
  The Maternal Anxiety in Relation to Infant Development Study is a prospective-longitudinal study of 306 women enrolled during early pregnancy and repeatedly assessed in seven waves during the peripartum period. Anxiety and depressive disorders prior to pregnancy were assessed in early pregnancy (T1) using the Composite International Diagnostic Interview for Women. Maternal birth injuries were assessed by questionnaire shortly after delivery (T4). Sexual problems during pregnancy (T2) as well as 4 months (T6) and 16 months (T7) postpartum were measured using the German version of the Massachusetts General Hospital Sexual Function Questionnaire.
  
  
  METHODS
  Impairment of sexual interest, arousal, orgasm, lubrication, and overall sexual satisfaction at T2, T6, and T7.
  
  
  RESULTS
  Rates of sexual problems generally increased from T2 to T6 and decreased from T6 to T7. Compared with women without anxiety and depressive disorders, those with comorbid anxiety and depressive disorders prior to pregnancy more often specified impairment of overall sexual satisfaction at T2 (odds ratio [OR] = 2.0) and T7 (OR = 2.1). In contrast, sexual problems were not pronounced in those with pure anxiety or pure depressive disorders, and women with pure anxiety disorders often reported even less impairment of sexual interest at T7 (OR = 0.5). Compared with women without birth injury, those with vaginal birth injury more often reported impairment of sexual interest (OR = 1.8) and lubrication (OR = 2.3) at T6.
  
  
  CONCLUSIONS
  Findings suggest that especially women with comorbid anxiety and depression and vaginal birth injury are at increased risk for sexual problems during pregnancy and after delivery and thus might benefit from targeted early interventions.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany. Electronic address: eva.asselmann@tu-dresden.de.
authors.forename: Eva
authors.initials: E
authors.lastname: Asselmann
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Hoyer
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Martini
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; Postpartum; Pregnancy; Sexual Problems