OBJECTIVE: To evaluate the long-term reproductive consequences that affect women who have experienced potentially life-threatening or life-threatening (near-miss) maternal complications. INTRODUCTION: Although advances have been made in reducing maternal death, few studies have investigated the long-term repercussions of significant events such as severe maternal morbidity and maternal near-misses. These repercussions may be long-lasting and negatively affect quality of life. METHODS: A total of 382 women who had experienced a potentially life-threatening pregnancy-related condition within the last five years were analyzed in this retrospective cohort study. A control group of 188 women who gave birth without complications was also included. Trained interviewers contacted the subjects by telephone and completed a pre-coded, structured questionnaire on reproductive health. Data were analyzed using odds ratios adjusted for age. The main outcome measures were occurrence and outcome of subsequent pregnancies. RESULTS: The estimated risk of becoming infertile as a result of tubal ligation or hysterectomy was 3.5 times higher in women who experienced a maternal near-miss or severe maternal morbidity during the index pregnancy as compared to controls. Likewise, the risk of complications in subsequent pregnancies was five times greater in women who had experienced severe maternal morbidity. However, no differences were found in the occurrence or number of subsequent pregnancies or perinatal outcome. CONCLUSION: The occurrence of a life-threatening or potentially life-threatening maternal condition reduces future reproductive potential and increases the risk of complications in subsequent pregnancies.

OBJECTIVE: To evaluate the prevalence of sexual dysfunction and its associated factors in middle-aged women with 11 years or more of formal education. METHODS: A cross-sectional, population-based study was carried out using an anonymous, self-response questionnaire. A total of 315 Brazilian-born women, 40-65 years of age with 11 years or more of schooling, participated in the study. The instrument used in the evaluation was based on the Short Personal Experiences Questionnaire. Sexual dysfunction was calculated from the mean score of sexual responsiveness (pleasure in sexual activities, excitation and orgasm), frequency of sexual activities and libido. Sociodemographic and clinical factors were evaluated. Poisson multiple regression analysis was carried out and the prevalence ratios with respective 95% confidence intervals (95%CI) were calculated. RESULTS: The prevalence of sexual dysfunction was 35.9% among our study population. Multiple regression analysis showed that sexual dysfunction was positively associated with older age (prevalence ratios=1.04; 95%CI:1.01-1.07) and with the presence of hot flashes (prevalence ratios=1.37; 95%CI:1.04-1.80). Having a sexual partner (PR=0.47; 95%CI:0.34-0.65) and feeling well or excellent (prevalence ratios= 0.68; 95%CI: 0.52-0.88) were factors associated with lower sexual dysfunction scores. CONCLUSIONS: Sexual dysfunction was present in more than one-third of women that were 40-65 years of age with 11 years or more of formal education. Within that age group, older age and hot flashes were associated with higher sexual dysfunction scores, whereas feeling well and having a sexual partner were associated with better sexuality.