(198) Sexual Attitudes and Function of Couples from the Preconception Period Through Pregnancy: A Prospective Couple-Based Study

Introduction Pregnancy is a critical period of sexual health evaluation due to the coexistence of various factors such as hormone production, body changes, mindset, and relations with others. The bulk of studies conducted on this topic have mainly concentrated on the sexual function of women during pregnancy. Very few studies employ a couple-based and longitudinal approach, and even fewer begin collecting data before conception. Tracking the changes in sexual attitudes and function from preconception through pregnancy using a couple-based, longitudinal design, this study aims to uncover new insights that can subjectively lead to developing couple-centered counseling in reproductive health care that is more effective. Objective This study aimed to monitor the changes in sexual activity of both women and men from preconception to the end of all three pregnancy trimesters, and also to assess how the sexual attitudes of couples affect their sexual function. Methods A descriptive, prospective, couple-based study was conducted between March and June 2025 at a primary health-care setting in a metropolitan region of Türkiye. The target population included pregnant women and their partners. The sample size was calculated using the known-population formula (N = 300, p = 0.25, q = 0.75, d = 0.05), resulting in n = 147 couples. Data were gathered at four assessment points: preconception, and the first, second, and third trimesters. The Female Sexual Function Index (FSFI) was used for women, the International Index of Erectile Function (IIEF) for men, and the Attitude Toward Sexuality During Pregnancy Scale (ASDPS) for both partners. All the instruments were validated in Turkish. Surveys were administered both face-to-face and online (via Google Forms). The statistical analyses included repeated-measures ANOVA and Pearson correlation tests, with p < 0.05 considered significant. Results From the trial,150 couples were thoroughly evaluated. The FSFI total score for the women decreased from 27.4 ± 4.6 (preconception) to 22.3 ± 3.8 (third trimester) (p < 0.001). The IIEF-EF domain for men also dropped from 27.1 ± 3.9 to 22.8 ± 4.1 (p<0.001). Sexual desire, arousal, lubrication, and satisfaction were the categories that showed the most significant decrease in women throughout the trimesters. In contrast, erectile and orgasmic functions were the most affected in men. The severity of erectile dysfunction gradually increased, reaching 52.3% during the third trimester (29.7% mild, 13.2% mild-moderate, 7.1% moderate, and 2.3% severe). Positive sexual attitude scores (ASDPS > 111.5) were strongly associated with higher FSFI and IIEF total scores in both partners (r = 0.46, p < 0.001). Couples with congruent and positive attitudes towards sexuality were significantly better in sexual function throughout all trimesters, as compared to those who had negative or discordant attitude. Conclusions Sexual function of couples decreases gradually from preconception until delivery; however, positive and shared sexual attitudes are the protective factors. Couple-based evaluation starting before conception gives a better comprehension of sexual adaptation during pregnancy. Inclusion of couple-centered sexual health counseling in antenatal care may contribute to maintaining sexual well-being and relational closeness during pregnancy. Disclosure No