Prevalence rates of sexual distress during pregnancy and influencing factors: a systematic review and meta-analysis

Background Sexual health during pregnancy remains underexplored, although pregnancy-related physiological, psychological, and sociocultural changes may affect women’s sexual well-being. In particular, sexual distress during pregnancy has not been comprehensively synthesized. Aim This systematic review and meta-analysis aimed to evaluate the prevalence of sexual distress during pregnancy and its associated factors. Methods A systematic review and meta-analysis was conducted. A comprehensive literature search was performed by two independent reviewers (October 2022–January 2026) across multiple databases, including Google Scholar, Web of Science, PubMed, PsycINFO, EBSCO, Turkish Medline, Türkiye Klinikleri, ULAKBİM-EKUAL, the National Thesis Center, and DOAJ. Study eligibility was determined using the PIOS framework. Methodological quality was assessed using Joanna Briggs Institute checklists. This systematic review and meta-analysis was registered in PROSPERO (CRD42023387791). Outcomes The primary outcome was the pooled prevalence of sexual distress during pregnancy and associated factors. Results A total of six studies with a combined sample size of 4295 were included in this systematic review and meta-analysis. The pooled prevalence of sexual distress during pregnancy was found to be 34.9% [95% CI: 27.9% to 42.7%], z = 4.89, P < .001; I2 = 95.1%, τ2 = 0.155. Sexual distress during pregnancy was associated with sociodemographic factors such as age, duration of marriage/relationship, education level, and region of residence; obstetric factors including number of children, parity, gestational week, pregnancy intention, pregnancy-related complaints, and adequacy of antenatal care; sexuality-related factors such as frequency of sexual intercourse, sexual function, sexual desire and satisfaction, perceiving intercourse as unsafe, fear of intercourse, certain sexual myths, fear of miscarriage, and sexual violence; and psychosocial factors including anxiety, stress, and depression during pregnancy, body image satisfaction before and during pregnancy, and relationship quality and satisfaction with the partner. Additionally, region of residence, marriage by choice, satisfaction with the marital relationship, pre-pregnancy sexual life, sexual satisfaction and desire during pregnancy, and receiving information/education about sexuality during pregnancy were also identified as factors associated with sexual distress. Clinical Implications Assessing sexual distress during antenatal care may help support sexual well-being during pregnancy. Strengths and Limitations This study included comprehensive database searches and advanced meta-analytic methods. However, heterogeneity across studies, inclusion of only English- and Turkish-language studies, and the inability to assess pre-pregnancy sexual distress should be considered. Conclusions This study demonstrated that sexual distress is prevalent among pregnant women and is influenced by various sociodemographic, obstetric, cultural, individual, and sexuality-related factors.