Clinical Question: Is sexual intercourse at term pregnancy associated with earlier labor and delivery?

Setting: Outpatient (primary care)

Study Design: Cohort (prospective)

Synopsis: A cohort of 93 women with low-risk singleton pregnancies who were at 37 or more weeks’ gestation was asked at weekly prenatal visits if they had engaged in penile-vaginal intercourse during the preceding week, and if they had, how many times. Women were excluded from the study if they had contraindications to vaginal intercourse for maternal or fetal reasons. Cervical examination was performed at the time of each visit, and a Bishop score was recorded. One half of the women (n = 47) reported sexual intercourse at any time during or after the 37th week of gestation and were defined as sexually active. Reported demographic parameters and parity did not differ between sexually active women and those who abstained, although race was not reported. Mean gestational age at delivery was 39.9 weeks (± 0.9 weeks) for sexually active women and 39.3 weeks (± 0.9 weeks) for abstaining women, which was statistically significant (P = .001).

There were fewer inductions of labor in the abstaining group (five out of 46 versus 12 out of 47; nonsignificant). Most of these inductions were elective at the patient’s request. Correspondingly, there was no increase in Bishop score in sexually active women. The study was too small to analyze the data on the basis of frequency of intercourse, but the results did not suggest that more frequent intercourse would change the study conclusions. There were no apparent complications observed for the women who chose to have intercourse at term pregnancy.

Bottom Line: Sexual intercourse at term pregnancy is not associated with earlier delivery. In this cohort, the mean gestational age at delivery was actually a few days older. (Level of Evidence: 2b)