Factors Affecting the Sexual Function of Pregnant Women

Eun Jung Oh; Moon Jeong Kim

doi:10.4069/kjwhn.2019.25.1.73

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Oh and Kim: Factors Affecting the Sexual Function of Pregnant Women

Original Article

Korean Journal of Women Health Nursing 2019; 25(1): 73-85.

Published online: 15 March 2019

DOI: https://doi.org/10.4069/kjwhn.2019.25.1.73

Factors Affecting the Sexual Function of Pregnant Women

Eun Jung Oh¹

, Moon Jeong Kim²

¹Assistant Professor, Department of Nursing, Choonhae College of Health Science, Ulsan, Korea.

²Associate Professor, Department of Nursing, Pukyong National University, Busan, Korea.

Corresponding author: Moon Jeong Kim. Department of Nursing, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan 48513, Korea. Tel: +82-51-629-5787, Fax: +82-51-629-5789, mjy7955@pknu.ac.kr

Received 25 January 2019 Revised 22 February 2019 Accepted 26 February 2019

Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine whether maternal attitude toward sex during pregnancy and health-related quality of life could influence sexual function of pregnant women.

Methods

In this study, 138 second and third trimester pregnant women completed self-report questionnaires during their visits to women's hospitals or community health centers to assess their general characteristics, attitude toward sex during pregnancy (PIES-M), health-related quality of life (EQ-5D), and sexual function (FSFI-6K). Multiple regression analysis was performed to test the research model with SPSS version 23.

Results

Pregnant women who had discontinued their sexual life after recognizing their pregnancy accounted for 27.5% of women questioned. The average sexual function score of pregnant women was higher in the second trimester than the third trimester. Attitude toward sex during pregnancy (β=−.38, p<.001), maintaining sexual life (β=.20, p=.028), health-related quality of life (β=.18, p=.030), and adverse symptoms during sex (β=.18, p=.042) were determinants of sexual function during pregnancy.

Conclusion

Nurses in antenatal care units need to help pregnant women maintain a positive attitude toward sexual activity during pregnancy and manage their health-related quality of life to maintain their sexual life during pregnancy.

Keywords: Pregnancy, Sexual behavior, Attitude, Health

Figures and Tables

Table 1

Differences of Sexual Function by General and Sexual Characteristics (N=138)

Variables	Categories	n(%)	Sexual function
Variables	Categories	n(%)	M±SD	t/F (p)
Age (year)	22–29	30 (21.8)	16.28±6.89	2.87 (.061)
	30–39	103 (74.6)	12.34±7.55
	40–43	5 (3.6)	10.50±9.85
	M±SD	32.62±4.27
Education	≤High school	26 (18.8)	12.50±7.68	0.89 (.449)
	College	39 (28.3)	15.08±7.08
	University	67 (48.6)	12.84±7.93
	≥Graduate school	6 (4.3)	9.75±5.85
Job	Yes	36 (26.1)	12.37±7.35	2.04 (.044)
Job	No	102 (73.9)	15.88±7.97	2.04 (.044)
Parity	0	78 (56.5)	11.44±7.62	2.56 (.012)
Parity	≥1	60 (43.5)	15.18±7.18	2.56 (.012)
Gestational period	2nd	23 (16.7)	17.06±5.81	2.81 (.009)
	3rd	115 (83.3)	12.47±7.72
	M±SD	33.06±5.96
Sex after recognizing pregnancy	Yes	99 (71.7)	14.71±7.28	4.81 (<.001)
	No	38 (27.6)	7.32±5.73
	Missing	1 (0.7)
Adverse symptom during sex	Yes	60 (43.5)	15.1±7.2	3.28 (.001)
Adverse symptom during sex	No	78 (56.5)	10.3±7.4	3.28 (.001)
Reason for sexless^†	Fear of fetal health deterioration	86 (62.3)
	Fear of pregnancy complication	58 (42.0)
	Wife's low sexual desire	15 (10.9)
	Husband's low sexual desire	9 (6.5)
	Miscellaneous	7 (5.1)
Kinds of adverse symptom^† (n=60)	Uterine contraction	66 (110.0)
	Vaginal pain	27 (45.0)
	Vaginal inflammation	7 (11.7)
	Bleeding	6 (10.0)
	Urinary tract inflammation	2 (3.3)
	Urinary incontinence	1 (1.7)
	Miscellaneous	8 (13.3)
Sex information source^†	Internet	86 (62.3)
	Books	73 (52.9)
	Spouse, friends or relatives	33 (23.9)
	Doctor	26 (18.8)
	Nurse	5 (3.6)

M±SD=mean±standard deviation.

^†Multiple response.

Table 2

Differences of PIES-M, EQ-5D, and FSFI-6K by Gestational Period (N=138)

Variables		2nd trimester (n=23)	3rd trimester (n=115)	t/x² (p)
Variables		n(%) or M±SD	n(%) or M±SD	t/x² (p)
PIES-M		23.43±4.00	23.22±5.43	0.18 (.856)
EQ-5D		0.93±0.09	0.88±0.12	2.06 (.041)
	Problem with mobility	1 (4.3)	24 (20.9)	3.53 (.076)^†
	Problem with self-care	1 (4.3)	13 (11.3)	1.02 (.465)^†
	Problem with usual activity	2 (8.7)	28 (24.3)	2.76 (.097)^‡
	Problem with pain/disability	8 (34.8)	73 (63.5)	6.51 (.011)^‡
	Problem with anxiety/depression	6 (26.1)	48 (41.7)	1.97 (.160)^‡
FSFI-6K		17.06±5.81	12.47±7.72	2.81 (.009)

PIES-M=Maternal Pregnancy Impact Expectations Scale; EQ-5D=Euro Quality of Life-5 Dimensions; FSFI-6K=Korean version of Female Sexual Function Index-6; M±SD=mean±standard deviation.

^†Fisher's exact test; ^‡Chi-square test.

Table 3

Correlation among PIES-M, EQ-5D and FSFI-6K (N=138)

Variables	r (p)
Variables	PIES-M	EQ-5D
PIES-M	1
EQ-5D	−.01 (.930)	1
FSFI-6K	−.48 (<.001)	.21 (.036)

PIES-M=Maternal Pregnancy Impact Expectations Scale; EQ-5D=Euro Quality of Life-5 Dimensions; FSFI-6K=Korean version of Female Sexual Function Index-6.

Table 4

Correlation among Items of PIES-M and FSFI-6K (N=138)

Items of PIES-M	r (p)
Items of PIES-M	1	2	3	4	5	6
1. The pregnancy has made sex awkward.	1
2. Having sex can cause a miscarriage.	.55 (<.001)	1
3. I feel anxious about having sex because of the pregnancy.	.56 (<.001)	.60 (<.001)	1
4. There are several sexual positions we can no longer do because of the pregnancy.	.22 (.011)	.20 (.018)	.21 (.013)	1
5. It is impossible to have an exciting sex life because of the pregnancy.	.35 (<.001)	.28 (.001)	.44 (<.001)	.37 (<.001)	1
6. I think it is difficult for my partner to find me sexually desirable because of the pregnancy.	.27 (.001)	.12 (.172)	.16 (.068)	.10 (.256)	.23 (.007)	1
7. FSFI-6K	−.48 (<.001)	−.30 (.002)	−.31 (.001)	−.16 (.112)	−.34 (<.001)	−.26 (.008)

PIES-M=Maternal Pregnancy Impact Expectations Scale; FSFI-6K=Korean version of Female Sexual Function Index-6.

Table 5

Influencing Factors of FSFI-6K (N=138)

Variables (reference)	B	SE	β	t	p	Tolerance	VIF
Constant	9.38	5.30		1.77	.080
Job (no)	2.00	1.44	.11	1.39	.168	.91	1.10
Parity (multipara)	1.77	1.22	.12	1.46	.148	.94	1.07
Gestational period (2Δ)	2.31	1.68	.11	1.37	.173	.88	1.13
Maintain sex life (yes)	3.81	1.71	.20	2.23	.028	.78	1.28
Adverse symptom during sex (yes)	2.81	1.36	.18	2.06	.042	.78	1.28
PIES-M	−0.53	0.12	−.38	−4.61	<.001	.91	1.10
EQ-5D	10.49	4.77	.18	2.20	.030	.92	1.08
R²=.43, Adjusted R²=.38
F=9.92, p<.001, Durbin-Watson=1.95

SE= standard error; VIF=Variance Inflation Factor; PIES-M=Maternal Pregnancy Impact Expectations Scale; EQ-5D=Euro Quality of Life-5 Dimensions; FSFI-6K=Korean version of Female Sexual Function Index-6.

Notes

^Funding This work was supported by a Research Grant of Pukyong National University (2017).

^{Conflict of Interest} The authors declared no conflict of interest.

^{Author Contributions}

Conceptualization: Oh EJ, Kim MJ.
Data curation: Oh EJ.
Formal analysis: Kim MJ.
Investigation: Oh EJ.
Methodology: Kim MJ.
Software: Kim MJ.
Validation: Oh EJ, Kim MJ.
Writing - original draft: Oh EJ, Kim MJ.
Writing - review & editing: Oh EJ, Kim MJ.

Summary Statement

• What is already known about this topic?

Pregnancy causes physical and psychological changes in women. It also causes and aggravates sexual dysfunction. Female sexuality and health status have been found to be factors affecting sexual function of pregnant women.
• What this paper adds?

Attitude toward sex during pregnancy, the maintenance of sexual life after pregnancy, and health status were found to be important predictors of sexual function of pregnant women.
• Implications for practice, education and/or policy

Nurses need to help pregnant women have a positive attitude toward sexual activity during pregnancy and encourage their sexual life during pregnancy to improve the sexual function of pregnant women.

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ORCID iDs

Eun Jung Oh
https://orcid.org/0000-0002-2276-9123

Moon Jeong Kim
https://orcid.org/0000-0003-4640-2649

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