Does Near Miss Compromise Sexual Function in Reproductive-Aged Women? A Comparative Cross-Sectional Study in Ahvaz, Iran

 Maternal near miss (MNM) is defined as any life-threatening event during pregnancy, delivery, or within six weeks after the termination of pregnancy.

 This cross-sectional study aimed to assess sexual function in women with (n = 140) and without MNM (n = 246).

 Eligible participants were women with MNM and basic literacy who had given birth at least 8 - 12 weeks prior to the study. Participants were recruited from Imam Khomeini and Taleghani hospitals, while women without MNM were recruited from two public health centers in Ahvaz. Data collection commenced in December 2020 and concluded in March 2021. A demographic questionnaire and the Female Sexual Function Index were used to collect the data. Data were analyzed using independent t-tests, chi-square tests, and multiple linear regression.

 The predominant mode of delivery among MNM women was cesarean section (70%, P < 0.05). The most common causes of MNM were preeclampsia (41.43%) and placenta accreta (24.29%), followed by hypertension and diabetes (17.86%). Women without MNM reported significantly higher scores in sexual satisfaction (β = 0.355, 95% CI: 0.019, 0.690, P = 0.035), lubrication (β = 0.707, 95% CI: 0.435, 0.980, P < 0.0001), sexual arousal (β = 0.394, 95% CI: 0.116, 0.522, P = 0.007), sexual desire (β = 0.319, 95% CI: 0.116, 0.522, p = 0.002), and total sexual function score (β = 1.768, 95% CI: 0.306, 3.230, P = 0.018). Women who had undergone cesarean section reported lower scores in sexual satisfaction (β = -0.646, 95% CI: -0.983, -0.309, P < 0.0001), orgasm (β = -0.620, 95% CI: -0.965, -0.275, P < 0.0001), sexual arousal (β = -0.473, 95% CI: 0.159, 0.439, P = 0.001), and total sexual function score (β = -3.181, 95% CI: -4.655, -1.707, P < 0.0001). Older women scored significantly lower in all components of sexual function except for pain.

 The study results indicated that all components of sexual function, except pain, were lower in women with MNM. A significantly higher number of women who had undergone cesarean section experienced MNM and sexual dysfunction. Health policymakers should focus not only on the causes of MNM, particularly cesarean sections, but also on assessing the sexual function of women affected by MNM.