Sexual Intercourse for Induction of Spontaneous Onset of Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
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| Institution: | 1. Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy;2. Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway;3. Department of Clinical Medicine, Faculty of Health Sciences, Women’s Health and Perinatology Research Group, UiT-The Arctic University of Norway, Tromsø, Norway;1. George Washington University School of Medicine and IntimMedicine Specialists, Washington, DC, USA;2. University of Virginia School of Medicine, Charlottesville, VA, USA;3. University Hospitals Cleveland Medical Center, MacDonald Women’s Hospital, Cleveland, OH, USA;4. Weill Cornell Medical College, New York, NY, USA;5. Institute for Sexual Medicine, San Diego, CA, USA;6. Stanford University School of Medicine, Palo Alto, CA, USA;1. Department of Midwifery, Medical School, Arak University of Arak University of Medical Sciences, Arak, Iran;2. Traditional and Complementary Medicine Research Center (TCMRC), Arak University of Arak University of Medical Sciences, Arak, Iran;3. Statistics Department, Medical School, Arak University of Medical Sciences, Arak, Iran;4. Department of Nursing Midwifery, Khoramabad, Lorestan, Iran;1. Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada;2. Department of Psychology, Queens University, Ontario, Canada;3. Department of Psychology, McGill University, Montreal, Quebec, Canada;4. Department of Obstetrics and Gynaecology, IWK Health Centre, University Avenue, Halifax, Nova Scotia, Canada;1. Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia;2. Public Health, Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia;3. Midwifery, Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia;4. Maternity Services, Central Coast Local Health District, Gosford NSW 2250, Australia;1. Department of Obstetrics and Gynaecology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, EU, Italy;2. Dept of Clinical Sciences and Community Health, University of Milan, Milan, EU, Italy;3. Dept of Woman Mother and Neonate, Buzzi Children’s Hospital, University of Milan, EU, Italy |
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| Abstract: | IntroductionSexual intercourse during pregnancy is commonly believed to trigger the onset of contractions and, therefore, labor. However, in low-risk pregnancies, there is neither association with preterm birth, premature rupture of membranes, or low birth weight, nor with spontaneous onset of labor at term.AimTo evaluate the effectiveness of sexual intercourse for spontaneous onset of labor at term in singleton pregnancies.MethodsThe systematic search was conducted using electronic databases from inception of each database to June 2019. Review of articles also included the abstracts of all references retrieved from the search. Inclusion criteria were randomized controlled trials comparing sexual intercourse in singleton low-risk pregnancies at term with controls (either reduced number of coitus or no coitus) for spontaneous onset of labor. Estimates were pooled using random-effects meta-analysis.Main Outcome MeasuresThe primary outcome was the incidence of spontaneous onset of labor. The summary measures were reported as summary relative risk with 95% CI using the random-effects model of DerSimonian and Laird.ResultsData extracted from 3 trials, including 1,483 women with singleton pregnancy at term and cephalic presentation, were analyzed. Women who were randomized in the sexual intercourse group had similar incidence of spontaneous onset of labor compared with control subjects (0.82% vs 0.80%; relative risk 1.02, 95% CI 0.98–1.07).Clinical ImplicationSexual intercourse should not be restricted in low-risk term pregnancies. Further studies are needed to properly evaluate the impact of orgasm, penetration, condom use, frequency of intercourse and other factors on induction of labor at term.Strength & limitationsOur study has several strengths. The three included trials had low risk of allocation bias; intention-to-treat analysis was used; this is the first meta-analysis on this issue so far. Limitations mainly depend on the design of the included studies. Firstly, compliance to the protocol relied on self-reporting by patients; in addition, not all the features of sexual intercourse could be adequately assessed (orgasm, nipple stimulation, sexual positions, etc.).ConclusionIn women with singleton, cephalic, low-risk pregnancies, sexual intercourse at term does not significantly increase the incidence of spontaneous onset of labor.Carbone L, De Vivo V, Saccone G, et al. Sexual Intercourse for Induction of Spontaneous Onset of Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Sex Med 2019;16:1787–1795. |
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| Keywords: | Sexual Intercourse Coitus Induction Of Labor Term Pregnancy Meta-Analysis |
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