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Two reviewers screened, extracted data and assessed risk of bias with JBI\/CASP checklists. Pooled effects were calculated with DerSimonian-Laird random-effects models; heterogeneity was explored with I\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-two studies met inclusion criteria; no meta-analysis pooled more than six studies, yielding low-certainty evidence. Exploratory pooled estimates suggested women with an OASI were 30% less likely to be sexually active at 3 months postpartum [RR 0.69 (95% CI 0.49-0.95),\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03] and more likely to suffer from dyspareunia at 3 months [RR 1.58 (95% CI 1.14-2.17),\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005] and &gt; 12 months postpartum [RR 1.69 (95% CI 1.31-2.17),\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001] when compared to the control group. FSFI outcomes were sparsely reported and largely derived from single studies; limited data suggested lower domain scores at 2 and 12 months among women with OASI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Available evidence is observational, heterogeneous and frequently lacks baseline sexual function assessment, substantially limiting causal inference. Quantitative findings should therefore be interpreted as exploratory. High-quality, baseline-controlled prospective studies using standardised outcome measures are needed. In the interim, proactive enquiry during the postnatal follow-up of OASI patients represents a low-risk, patient-centred approach to addressing under-reported sexual health concerns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06632-5","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:28:04Z","timestamp":1775831284000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sexual Function After Obstetric Anal Sphincter Injuries (OASIs): A Systematic Review and Meta-Analysis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3986-4412","authenticated-orcid":false,"given":"N.","family":"Elsaid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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