title: Sexual function and sexual satisfaction and its association with fertility and childbearing intention  

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Childbearing intention is of particular importance as a unique factor of population growth at the global level. The purpose of this study is to investigate the relationship between sexual function and sexual satisfaction with fertility and childbearing intention. Methods : This descriptive study was conducted between May 2023 and July 2024 on 300 married women of reproductive age. In order to collect data, a checklist consisting of demographic characteristics, FSFI Rosen Women's Sexual function Questionnaire, Larson's Sexual Satisfaction Questionnaire, and Rad and savabi Questionnaire were used. Data were analyzed using descriptive statistics (mean, standard deviation, frequency and percentage) by spss software version 21. Results : Based on the findings, there was a significant relationship between childbearing intention and duration of marriage (P<0.05). In this way, Women who had been married longer were more likely to have children. The results of the Chi-square test showed that there is a significant relationship between average and good sexual function with low childbearing intention, as well as a significant relationship between sexual satisfaction and childbearing intention. (P<0.000) Conclusions : According to the results of the study, as sexual satisfaction increases, childbearing intention to increase. There was no significant relationship between sexual function and childbearing intention. Sexual function Sexual satisfaction Childbearing Fertility Introduction Fertility style is a branch of lifestyle that focuses on childbearing behavior patterns. Therefore, one of the most important factors affecting the fertility rate is the reproductive style. Today, Iran has deep changes in all cultural, economic, social and demographic dimensions and is in the transition stage from traditional to modern patterns [1, 2]. According to the available information of the Statistics Center, the population growth rate has decreased from 2.5% in 1991 to 1.24% in 2016 [3]. The rapid decrease in the fertility rate in Iran and disrupting the balance of the age pyramid towards old age can cause irreparable economic and social damage to the country [1]. This rapid decrease in fertility has attracted the attention of politicians. To explain the decrease in fertility, several factors have been pointed out by demographers. The increase in education has provided the basis for changing the thoughts and ideas of couples regarding marriage and childbearing. Studies have shown that the ideals of the previous generation have become closer to the ideals of the young generation[4]. .A review of studies related to fertility in Iran shows that fertility decline in recent decades is closely related to structural factors, family developments, changing childbearing patterns, improving women's status and increasing women's independence, and individual characteristics such as age and educational achievement [5-7]. Deciding on having children is one of the important events in a couple's life and in turn is influenced by a set of demographic, economic, social and individual variables, Despite the studies that have been conducted in this field, the study of childbearing tendencies is still very important for two reasons. Firstly, awareness of the fertility preferences and intentions of individuals helps to predict the future fertility rate of the society; Second, in societies where there is a difference between the ideal number of children and the actual number of children, the study of fertility intention makes our knowledge more complete about the factors affecting the failure of primary preferences and the formation of the fertility gap [8]. In addition to demographic, economic and social variables, the quality of relationships between spouses also affects fertility [9, 10]. Among the approaches that exist regarding the effect of relationship quality on fertility, the theory of the value of children based on the uncertainty-reduction assumption, among many other hypotheses, suggests that couples who do not have a good marital relationship and are dissatisfied with their marriage may use childbearing as a strategy to increase solidarity and thus reduce marital uncertainty [11]. In explaining the factors affecting childbearing, previous studies have mainly focused on structural variables or on the position and attitudes of women and sometimes men. Considering that the relationship between women's sexual function and sexual satisfaction with their childbearing intention has been given less attention, therefore, the purpose of this study is to investigate the relationship between women's sexual function and sexual satisfaction with their childbearing intention of women. Materials and Methods This study is a descriptive-analytical cross-sectional study. Sampling was done by cluster and random method. The criteria for inclusion in the study are women of reproductive age, married (at least one year of marriage history), not pregnant. The exclusion criteria are not completing the questionnaire, suffering from diseases that put the person on the list of high-risk women for pregnancy, and a positive pregnancy test. Sampling was done as a cluster in several steps. At first, based on the census of 2015 and based on statistical blocks and according to the social class level of Kermanshah city, it was examined in three levels (poor, middle and good), then one health service center was randomly selected in each class. In each class, based on the population covered and the proportion of married women in the region, the share of the selected households was allocated according to the sample size for each class. The sample size was calculated through Cochran's formula and taking into account the error level of 0.05,q = 1.96, z = 0.5,N = 201319, 284 people, and according to the possibility of dropping the sample size, 300 people. In order to collect data, a checklist consisting of demographic characteristics, Rosen FSFI female sexual function questionnaire, Larson sexual satisfaction questionnaire and Rad and savabi questionnaire were used. FSFI scoring system is 0 to 5 for sexual desire, 0 to 5 sexual arousal, 0 to 5 vaginal moisture, 0 to 5 sexual satisfaction, 0 to 5 orgasm, 0 to 5 pain during intercourse (dysparony). The lowest score is 2 and the highest score is 36, and a score below 26.55 is considered as sexual dysfunction [12]. In this study, a score below 26.55 was considered poor sexual function, 26.55-66.6 average sexual function, and a score above 66.7 was considered good sexual function. Larson sexual satisfaction questionnaire was used to measurement sexual satisfaction. This questionnaire contains 25 questions, 13 negative questions and 12 positive questions. Answers are scored on a 5-point Likert scale. A score of less than 50 indicates no sexual satisfaction, a score of 75-51 is equivalent to low sexual satisfaction, 76-100 is equivalent to moderate sexual satisfaction, and more than 100 indicates high sexual satisfaction [13]. To measure women's childbearing intention, the standard questionnaire of women's childbearing intention of Rad and savabi was used. This questionnaire has 16 questions and the scoring of the questionnaire is on a 5-point Likert scale. The score of the questionnaire ranged from 16 to 80. A score of less than 20 indicates a childbearing intention to very low or no childbearing intention, a score of 21-40 is equivalent to a low childbearing intention, a score of 41-60 is equivalent to a moderate childbearing intention, and a score greater than 61 indicates a high childbearing intention [2]. Data was collected by questionnaire and analyzed by SPSS 21 software. Result The average age of women participating in the study was 35.35±7.44 and the average age of their husbands was 39.73±8.24 years. The average number of children is 1.38 ± 1.30 and the average number of ideal children is 1.84 ± 0.81. Other demographic information is reported in Table 1. The results of the study showed that most of the women have good sexual function (59.7%), average sexual satisfaction (47.7%) and average childbearing intention (74.7%). The results of Pearson's correlation test showed that there is no significant relationship between age, spouse's age and the childbearing intention (P>0.05), but the relationship between the number of years of marriage and the moderate and high childbearing intention is significant (P<0.05). The relationship between the number of children and the low childbearing intention is significant, which means that with the increase in the number of children, the childbearing intention is lower (P0.05). The results of the chi-square test show that there is a significant relationship between average and good sexual function and low childbearing intention. The relationship between low sexual satisfaction and low childbearing intention, moderate sexual satisfaction with moderate childbearing intention and high sexual satisfaction with high childbearing intention is significant (P<0.000). In general, the results of the study showed that women who had better sexual function have less childbearing intention, and those who have higher sexual satisfaction have more childbearing intention. Discussion The present study was conducted with the aim of investigating the relationship between sexual function and sexual satisfaction with the childbearing intention. Although in most studies, the relationship between women's age and childbearing intention is significant [ 14 , 15 ] and women who have a higher age at the beginning of cohabitation tend to be more fertile[ 16 ], But the results of the present study showed that there is no significant relationship between the age and the age of the spouse with the tendency to childbearing. This difference in the results could be because the childbearing intention of the study participants was average, but in other studies women who were older had a high fertility tendency. Previous studies have shown that, parents who had a child had a lower desire to have another child [ 17 , 18 ]. In the present study, the relationship between the number of children and childbearing intention was inverse, and with the increase in the number of children, the childbearing intention was lower. Another finding of the study is that there is a significant relationship between the years of marriage and childbearing intention, this means that with the increase in the number of years of marriage, the tendency towards fertility and have a children was higher. In the study of Kasiri et al., the duration of marriage had a significant relationship with having children, and couples who had lived together for more years had a greater desire to have children[ 19 ]. Motlagh et al. concluded that with the increase in the duration of marriage, the tendency of people to be fertile increases [ 20 ]. Although the results of the studies show that a combination of cultural, socio-economic characteristics play a decisive and significant role in predicting the possibility of having children among women [ 21 , 22 ] and solving economic problems has been mentioned as the most important reason for reluctance to have children [ 23 ]. Contrary to the results of other studies, in the present study, economic status had no significant relationship with childbearing intention. This result could be due to the fact that a wide range of participants had a moderate economic status. The results showed that women who had better sexual function had a less childbearing intention and those with higher sexual satisfaction had higher childbearing intention. Oindi et al.'s study did not show a significant relationship between women's sexual function and their fertility [ 24 ]. In contrast, Witting et al showed that multiparous women had fewer problems with orgasm, pain, and overall sexual function and sexual satisfaction compared to nulliparous women [ 25 ]. In contrast, Witting et al showed that multiparous women had fewer problems with orgasm, pain, and overall sexual function and sexual satisfaction compared to nulliparous women. Sexual satisfaction and marital relations has a significant effect on people's intention to have children, and women who have a higher level of sexual satisfaction have a higher childbearing intention [ 26 – 28 ]. The quality of married life has a positive effect on childless women's intention to have children. Also, women whose marital relationship quality is medium and high are more likely to have more children despite having child [ 9 ]. The positive dimension of the quality of married life in childless people and in people with only one child has a significant effect on the intention to have another child, in other words, a higher quality of married life is effective in getting out of childlessness and single child [ 10 , 29 ]. Conclusion Results of this study showed that, relationship between the number of children and childbearing intention was inverse, with the increase in the number of children, the childbearing intention was lower.As well as With the increase in the number of years of marriage, the tendency towards fertility and have a children was higher. There is a significant relationship between average and good sexual function and low childbearing intention. Women who have higher sexual satisfaction they have more childbearing intention. Declarations Acknowledgment The authors would like to acknowledge the help of all the participants involved in this study. Declaration Competing interests The authors declare no competing interests Ethics approval and consent to participate This study was approved by the Ethics Committee of Kermanshah University of Medical Sciences with the ethics code (IR.KUMS.REC.1402.216). Accordance with the Declaration of Helsinki, The participants expressed their informed consent to participate in the study. The participants were assured that the data would remain confidential. They were also assured that they could withdraw from the research at any stage of the study. Funding This research was extracted from which was funded by Kermanshah University of Medical Sciences, Kermanshah, Iran Authors' contributions SZ participated in the study design. SZ, and MT participated in data collection and were part of the community design teams. SZ, MT, and MN participated in the design research analysis. SZ, and MO developed initial drafts of the manuscript. All authors have read and approved the final manuscript. Data availability The data supporting the conclusions of this article are included within the article. Author details 1 PhD in reproductive health, Kermanshah city health center, Family health department, Kermanshah University of Medical Science, Kermanshah, Iran. Email: [email protected] 2 Medical doctor, Kermanshah city health center, Kermanshah University of Medical Science, Kermanshah, Iran. Email: [email protected] 3 Medical doctor, Kermanshah city health center, Kermanshah University of Medical Science, Kermanshah, Iran. Email: [email protected] 4 Bachelor in midwifery, Kermanshah city health center, Family health department, Kermanshah University of Medical Science, Kermanshah, Iran.Email: [email protected] References Hosseini H, Haghshenas NM, editors. Dynamics of development and fertility convergence in Muslim countries. th IUSSP International population conference; 2009. (Text in Persian) Rad F, Savabi H. Investigation on tendency to fertility and its related social factors (a case study of married women aged 15 to 50 in Tabriz). Journal of woman and family studies. 2015;3(1):127-55. https://doi.org/10.22051/jwfs.2015.2199 Survey of Iran's population indices and its comparison with neighboring countries with emphasis on the ranking of each index among neighboring countries and the world. Country Registration Organization. Deputy of Information Technology and Population Statistics. Population and Migration Information and Statistics Office. (Text in Persian) Bokaie M, Simbar M, Ardekani SM, Majd HA. Women's beliefs about infertility and sexual behaviors: A qualitative study. Iranian journal of nursing and midwifery research. 2016 Jul 1;21(4):379-84. https://doi.org/10.4103/1735-9066.185579 Riahi S, Ghorashi Z, Sahebi Z. Investigation of women's Reproductive History, attitude toward childbearing and associated factors in Rafsanjan City, Iran, 2021. https://doi.org/10.21203/rs.3.rs-4822608/v1 Shavazi MA, Selehi ZK. An assessment on the impact of women's autonomy, education and social participation on childbearing intention in Sirjan city. Woman in Culture and Art (Women's Research). 2013;11(1):45-64. https://doi.org/10.22059/jwdp.2013.35477 Zare Z, Kiaetabar R, Laal Ahangar M. Fertility motivations and its related factors in women of reproductive age attended health centers in Sabzevar, Iran. Journal of Midwifery and Reproductive Health. 2019;7(1):1551-9. https://doi.org/10.22038/jmrh.2018.28116.1303 Farahani FK. The role of attitude and gender division of labor in women's fertility preferences and intentions Men of Tehran. Population studies. 2017;5(3,95-125). (Text in Persian) Lainiala L. The impact of relationship quality on childbearing in Finland. Finnish Yearbook of Population Research. 2011:31-47. https://doi.org/10.23979/fypr.45064 Rijken AJ, Thomson E. Partners’ relationship quality and childbearing. Social science research. 2011;40(2):485-97. https://doi.org/10.1016/j.ssresearch.2010.10.001 Friedman D, Hechter M, Kanazawa S. A theory of the value of children. Demography. 1994;31(3):375-401. https://doi.org/10.2307/2061749 Mohamadi K, Heidari M, Faghihzadeh S. Validity of persian female sexual function index (FSFI). Payesh: J Iranian Instit Health Sci Res. 2008;2(7):269-78. http://payeshjournal.ir/article-1-658-en.html Bahrami N, Yaghoob Zadeh A, Sharif Nia H, Soliemani MA, Haghdoost AA. Validity and reliability of the persian version of Larson sexual satisfaction questionnaire in couples. Journal of Kerman University of Medical Sciences. 2016;23(3):344-56. (Text in Persian) Hanappi D, Ryser V-A, Bernardi L, Le Goff J-M. Changes in employment uncertainty and the fertility intention–realization link: An analysis based on the Swiss household panel. European Journal of Population. 2017;33:381-407. https://doi.org/10.1007/s10680-016-9408-y Hashemzadeh M, Shariati M, Mohammad Nazari A, Keramat A. Childbearing intention and its associated factors: A systematic review. Nursing open. 2021;8(5):2354-68. https://doi.org/10.1002/nop2.849 Rijken AJ, Liefbroer AC. The Influence of Partner Relationship Quality on Fertility: L’influence de la qualité de la relation avec le partenaire sur la fécondité. European Journal of Population/Revue européenne de Démographie. 2009;25:27-44. https://doi.org/10.1007/s10680-008-9156-8 Esfehani RJ, Kamalimanesh B, Dashti S, Esfehani AJ. Factors Influencing the Decision to Have Child Among Iranian Couples; An Online Survey. https://doi 10.15296/ijwhr.2019.48 Azmoude E, Barati-Far S, Behnam H, Aradmehr M. Relationship between gender preference, birth interval and sex composition on fertility behavior. Journal of Torbat Heydariyeh University of Medical Sciences. 2015;3(3):15-8. http://jms.thums.ac.ir/article-1-308-en.html Kasiri M. Socio-cultural and Demographic Factors Affecting Fertility "A case study of women aged 15-49 in the city of Varamin, Master's Degree, university of Tehran, Faculty of social sciences. Tehran, Iran (Text in Persian). 2008. Motlagh ME, Taheri M, Eslami M. Factors affecting the fertility preferences in Iranian ethnic groups. Nursing And Midwifery Journal. 2016;14(6):485-95. http://unmf.umsu.ac.ir/article-1-2845-en.html Abbasi-Shavazi MJ, Mahmoudian H, Sadeghi R, Ghorbani Z. The impact of value-attitude orientations on the ideals of childbearing in Iran. Journal of Population Association of Iran. 2019;13(26):37-66. (Text in Persian) Sadeghi H, Saraie H. Effective factors on mothers’ inclination to have children in tehran hannaneh sadat sadeghi, hasan saraie. Social Development & Welfare Planning. 2016;7(27):1-32. https://doi.org/10.22054/qjsd.2016.5920 Haerimehrizi AA, Tavousi M, Sadighi J, Motlagh ME, Eslami M, Naghizadeh F, et al. Reasons for fertility desire and disinterest among Iranian married adults: A population-based study. Payesh (Health Monitor). 2017;16(5):637-45. : http://payeshjournal.ir/article-1-86-en.html Oindi FM, Murage A, Lema VM, Mukaindo AM. Association of female sexual dysfunction and fertility: a cross sectional study. Fertility research and practice. 2019;5:1-11. https://doi.org/10.1186/s40738-019-0065-9 Witting K, Santtila P, Alanko K, Harlaar N, Jern P, Johansson A, et al. Female sexual function and its associations with number of children, pregnancy, and relationship satisfaction. Journal of Sex & Marital Therapy. 2008;34(2):89-106. https://doi.org/10.1080/00926230701636163 Bagi M. Prevalence, Reasons and Consequences of Childlessness in the World and Iran: A Systematic Review. Journal of Population Association of Iran. 2023;18(35):97-148. 20.1001.1.20083742.1402.18.35.3.8 Shreffler KM, Gibbs L, Tiemeyer S, McQuillan J, Greil AL. Is reproductive orientation associated with sexual satisfaction among partnered US women? Archives of sexual behavior. 2021;50(6):2459-69. https://doi.org/10.1007/s10508-021-01984-z Araban M, Karimy M, Armoon B, Zamani-Alavijeh F. Factors related to childbearing intentions among women: a cross-sectional study in health centers, Saveh, Iran. Journal of the Egyptian Public Health Association. 2020;95:1-8. https://doi.org/10.1186/s42506-020-0035-4 Modiri F, Ghazi Tabatabaie M. A Study on the Effects of the Quality of Marital Life on the Childbearing Intention. Sociology of Social Institutions. 2019;5(12):73-94. https://doi.org/10.22080/ssi.1970.2133 Tables Tables 1 to 4 are available in the Supplementary Files section. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6213354","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":453547418,"identity":"7faa7c93-11fd-4aa2-8905-d175c516308e","order_by":0,"name":"sanaz zangeneh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYBAC+QYkDjMQy4EYBx7g0WJwAE2LMVhLAj4tyByQlkSwtXi1sJ89+PHHH7s8effeg48LGLalzw87/BBoi52cbgN2LfI9eckSEjzJxYZnziUbz2C4nbvxdpoBUEuysdkB7FoYDuQYSBhIMCdunJFjJs0D0jI7AaTlQOI2XFrOvzH+kWBQn7hx/hvz30At6Yaz0z/g13Ijx0ziQMLhxPkSPGbMQC0J8tI5+G0xuPHGzLLhwPHEDTw5xtI8BrcNN0jnFBxIMMDtF/n+HOObP/5UJ85vP2P4mafitrz87PTNHz5U2Mnh9D7cOrACAyQGQQBPOShJaBSMglEwCkYBEAAA0T1jJRNbhQMAAAAASUVORK5CYII=","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"sanaz","middleName":"","lastName":"zangeneh","suffix":""},{"id":453547419,"identity":"f07886ab-60ab-40ff-ae63-b96312c3a011","order_by":1,"name":"mohammadreza naderi","email":"","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"mohammadreza","middleName":"","lastName":"naderi","suffix":""},{"id":453547420,"identity":"6f09d881-9eef-453f-b8f8-2df61fc44e79","order_by":2,"name":"mazyar tahmasebi","email":"","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"mazyar","middleName":"","lastName":"tahmasebi","suffix":""},{"id":453547421,"identity":"9fa15024-a880-4542-af2d-96b5895233c7","order_by":3,"name":"maryam ovasi","email":"","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"maryam","middleName":"","lastName":"ovasi","suffix":""}],"badges":[],"createdAt":"2025-03-12 15:23:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6213354/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6213354/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83966017,"identity":"ed234d02-8a0b-4202-b997-ba8a18f5d76e","added_by":"auto","created_at":"2025-06-05 06:47:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":398361,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6213354/v1/a316da92-ab28-4637-98ad-94ee8a48bf83.pdf"},{"id":82348330,"identity":"0fe1abc7-dd92-4e61-8777-795a7bb897c4","added_by":"auto","created_at":"2025-05-09 10:40:54","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":37477,"visible":true,"origin":"","legend":"","description":"","filename":"Tables1234.docx","url":"https://assets-eu.researchsquare.com/files/rs-6213354/v1/4831f0b5e7367576c5f73d44.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"title: Sexual function and sexual satisfaction and its association with fertility and childbearing intention ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFertility style is a branch of lifestyle that focuses on childbearing behavior patterns. Therefore, one of the most important factors affecting the fertility rate is the reproductive style. Today, Iran has deep changes in all cultural, economic, social and demographic dimensions and is in the transition stage from traditional to modern patterns [1, 2]. According to the available information of the Statistics Center, the population growth rate has decreased from 2.5% in 1991 to 1.24% in 2016 [3]. The rapid decrease in the fertility rate in Iran and disrupting the balance of the age pyramid towards old age can cause irreparable economic and social damage to the country [1]. This rapid decrease in fertility has attracted the attention of politicians. To explain the decrease in fertility, several factors have been pointed out by demographers. The increase in education has provided the basis for changing the thoughts and ideas of couples regarding marriage and childbearing. Studies have shown that the ideals of the previous generation have become closer to the ideals of the young generation[4]. .A review of studies related to fertility in Iran shows that fertility decline in recent decades is closely related to structural factors, family developments, changing childbearing patterns, improving women\u0026apos;s status and increasing women\u0026apos;s independence, and individual characteristics such as age and educational achievement [5-7]. Deciding on having children is one of the important events in a couple\u0026apos;s life and in turn is influenced by a set of demographic, economic, social and individual variables, Despite the studies that have been conducted in this field, the study of childbearing tendencies is still very important for two reasons. Firstly, awareness of the fertility preferences and intentions of individuals helps to predict the future fertility rate of the society; Second, in societies where there is a difference between the ideal number of children and the actual number of children, the study of fertility intention makes our knowledge more complete about the factors affecting the failure of primary preferences and the formation of the fertility gap [8]. In addition to demographic, economic and social variables, the quality of relationships between spouses also affects fertility [9, 10]. Among the approaches that exist regarding the effect of relationship quality on fertility, the theory of the value of children based on the uncertainty-reduction assumption, among many other hypotheses, suggests that couples who do not have a good marital relationship and are dissatisfied with their marriage may use childbearing as a strategy to increase solidarity and thus reduce marital uncertainty [11]. In explaining the factors affecting childbearing, previous studies have mainly focused on structural variables or on the position and attitudes of women and sometimes men. Considering that the relationship between women\u0026apos;s sexual function and sexual satisfaction with their childbearing intention has been given less attention, therefore, the purpose of this study is to investigate the relationship between women\u0026apos;s sexual function and sexual satisfaction with their childbearing intention of women.\u003c/p\u003e\n"},{"header":"Materials and Methods","content":"\u003cp\u003eThis study is a descriptive-analytical cross-sectional study. Sampling was done by cluster and random method. The criteria for inclusion in the study are women of reproductive age, married (at least one year of marriage history), not pregnant. The exclusion criteria are not completing the questionnaire, suffering from diseases that put the person on the list of high-risk women for pregnancy, and a positive pregnancy test. Sampling was done as a cluster in several steps. At first, based on the census of 2015 and based on statistical blocks and according to the social class level of Kermanshah city, it was examined in three levels (poor, middle and good), then one health service center was randomly selected in each class. In each class, based on the population covered and the proportion of married women in the region, the share of the selected households was allocated according to the sample size for each class. The sample size was calculated through Cochran\u0026apos;s formula and taking into account the error level of 0.05,q = 1.96, z = 0.5,N = 201319, 284 people, and according to the possibility of dropping the sample size, 300 people. In order to collect data, a checklist consisting of demographic characteristics, Rosen FSFI female sexual function questionnaire, Larson sexual satisfaction questionnaire and Rad and savabi questionnaire were used. FSFI scoring system is 0 to 5 for sexual desire, 0 to 5 sexual arousal, 0 to 5 vaginal moisture, 0 to 5 sexual satisfaction, 0 to 5 orgasm, 0 to 5 pain during intercourse (dysparony). The lowest score is 2 and the highest score is 36, and a score below 26.55 is considered as sexual dysfunction [12]. In this study, a score below 26.55 was considered poor sexual function, 26.55-66.6 average sexual function, and a score above 66.7 was considered good sexual function. Larson sexual satisfaction questionnaire was used to measurement sexual satisfaction. This questionnaire contains 25 questions, 13 negative questions and 12 positive questions. Answers are scored on a 5-point Likert scale. A score of less than 50 indicates no sexual satisfaction, a score of 75-51 is equivalent to low sexual satisfaction, 76-100 is equivalent to moderate sexual satisfaction, and more than 100 indicates high sexual satisfaction [13]. To measure women\u0026apos;s childbearing intention, the standard questionnaire of women\u0026apos;s childbearing intention of Rad and savabi was used. This questionnaire has 16 questions and the scoring of the questionnaire is on a 5-point Likert scale. The score of the questionnaire ranged from 16 to 80. A score of less than 20 indicates a childbearing intention to very low or no childbearing intention, a score of 21-40 is equivalent to a low childbearing intention, a score of 41-60 is equivalent to a moderate childbearing intention, and a score greater than 61 indicates a high childbearing intention [2]. Data was collected by questionnaire and analyzed by SPSS 21 software.\u003c/p\u003e\n"},{"header":"Result","content":"\u003cp\u003eThe average age of women participating in the study was 35.35\u0026plusmn;7.44 and the average age of their husbands was 39.73\u0026plusmn;8.24 years. The average number of children is 1.38 \u0026plusmn; 1.30 and the average number of ideal children is 1.84 \u0026plusmn; 0.81. Other demographic information is reported in Table 1.\u003c/p\u003e\n\u003cp\u003eThe results of the study showed that most of the women have good sexual function (59.7%), average sexual satisfaction (47.7%) and average childbearing intention (74.7%).\u003c/p\u003e\n\u003cp\u003eThe results of Pearson\u0026apos;s correlation test showed that there is no significant relationship between age, spouse\u0026apos;s age and the childbearing intention (P\u0026gt;0.05), but the relationship between the number of years of marriage and the moderate and high childbearing intention is significant (P\u0026lt;0.05). The relationship between the number of children and the low childbearing intention is significant, which means that with the increase in the number of children, the childbearing intention is lower (P\u0026lt;0.05). The results of the one way Anova test showed that there is no relationship between economic conditions and childbearing intention (P\u0026gt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results of the chi-square test show that there is a significant relationship between average and good sexual function and low childbearing intention. The relationship between low sexual satisfaction and low childbearing intention, moderate sexual satisfaction with moderate childbearing intention and high sexual satisfaction with high childbearing intention is significant (P\u0026lt;0.000). In general, the results of the study showed that women who had better sexual function have less childbearing intention, and those who have higher sexual satisfaction have more childbearing intention.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study was conducted with the aim of investigating the relationship between sexual function and sexual satisfaction with the childbearing intention. Although in most studies, the relationship between women's age and childbearing intention is significant [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and women who have a higher age at the beginning of cohabitation tend to be more fertile[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], But the results of the present study showed that there is no significant relationship between the age and the age of the spouse with the tendency to childbearing. This difference in the results could be because the childbearing intention of the study participants was average, but in other studies women who were older had a high fertility tendency. Previous studies have shown that, parents who had a child had a lower desire to have another child [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In the present study, the relationship between the number of children and childbearing intention was inverse, and with the increase in the number of children, the childbearing intention was lower. Another finding of the study is that there is a significant relationship between the years of marriage and childbearing intention, this means that with the increase in the number of years of marriage, the tendency towards fertility and have a children was higher. In the study of Kasiri et al., the duration of marriage had a significant relationship with having children, and couples who had lived together for more years had a greater desire to have children[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Motlagh et al. concluded that with the increase in the duration of marriage, the tendency of people to be fertile increases [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Although the results of the studies show that a combination of cultural, socio-economic characteristics play a decisive and significant role in predicting the possibility of having children among women [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] and solving economic problems has been mentioned as the most important reason for reluctance to have children [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Contrary to the results of other studies, in the present study, economic status had no significant relationship with childbearing intention. This result could be due to the fact that a wide range of participants had a moderate economic status. The results showed that women who had better sexual function had a less childbearing intention and those with higher sexual satisfaction had higher childbearing intention. Oindi et al.'s study did not show a significant relationship between women's sexual function and their fertility [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In contrast, Witting et al showed that multiparous women had fewer problems with orgasm, pain, and overall sexual function and sexual satisfaction compared to nulliparous women [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In contrast, Witting et al showed that multiparous women had fewer problems with orgasm, pain, and overall sexual function and sexual satisfaction compared to nulliparous women. Sexual satisfaction and marital relations has a significant effect on people's intention to have children, and women who have a higher level of sexual satisfaction have a higher childbearing intention [\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The quality of married life has a positive effect on childless women's intention to have children. Also, women whose marital relationship quality is medium and high are more likely to have more children despite having child [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The positive dimension of the quality of married life in childless people and in people with only one child has a significant effect on the intention to have another child, in other words, a higher quality of married life is effective in getting out of childlessness and single child [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eResults of this study showed that, relationship between the number of children and childbearing intention was inverse, with the increase in the number of children, the childbearing intention was lower.As well as With the increase in the number of years of marriage, the tendency towards fertility and have a children was higher. There is a significant relationship between average and good sexual function and low childbearing intention. Women who have higher sexual satisfaction they have more childbearing intention.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge the help of all the participants involved in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of Kermanshah University of Medical Sciences with the ethics code (IR.KUMS.REC.1402.216). Accordance with the Declaration of Helsinki, The participants expressed their informed consent to participate in the study. The participants were assured that the data would remain confidential. They were also assured that they could withdraw from the research at any stage of the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was extracted from which was funded by Kermanshah University of Medical Sciences, Kermanshah, Iran\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSZ participated in the study design. SZ, and MT participated in data collection and were part of the community design teams. SZ, MT, and MN participated in the design research analysis. SZ, and MO developed initial drafts of the manuscript. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the conclusions of this article are included within the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003ePhD in reproductive health, Kermanshah city health center, Family health department, Kermanshah University of Medical Science, Kermanshah, Iran. Email: [email protected]\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eMedical doctor, Kermanshah city health center, Kermanshah University of Medical Science, Kermanshah, Iran. Email:[email protected]\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eMedical doctor, Kermanshah city health center, Kermanshah University of Medical Science, Kermanshah, Iran. Email:[email protected]\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e4\u003c/sup\u003eBachelor in midwifery, Kermanshah city health center, Family health department, Kermanshah University of Medical Science, Kermanshah, Iran.Email:[email protected]\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHosseini H, Haghshenas NM, editors. Dynamics of development and fertility convergence in Muslim countries. th IUSSP International population conference; 2009. (Text in Persian)\u003c/li\u003e\n\u003cli\u003eRad F, Savabi H. Investigation on tendency to fertility and its related social factors (a case study of married women aged 15 to 50 in Tabriz). Journal of woman and family studies. 2015;3(1):127-55. https://doi.org/10.22051/jwfs.2015.2199\u003c/li\u003e\n\u003cli\u003eSurvey of Iran\u0026apos;s population indices and its comparison with neighboring countries with emphasis on the ranking of each index among neighboring countries and the world. Country Registration Organization. Deputy of Information Technology and Population Statistics. Population and Migration Information and Statistics Office. (Text in Persian)\u003c/li\u003e\n\u003cli\u003eBokaie M, Simbar M, Ardekani SM, Majd HA. Women\u0026apos;s beliefs about infertility and sexual behaviors: A qualitative study. Iranian journal of nursing and midwifery research. 2016 Jul 1;21(4):379-84. https://doi.org/10.4103/1735-9066.185579\u003c/li\u003e\n\u003cli\u003eRiahi S, Ghorashi Z, Sahebi Z. Investigation of women\u0026apos;s Reproductive History, attitude toward childbearing and associated factors in Rafsanjan City, Iran, 2021. https://doi.org/10.21203/rs.3.rs-4822608/v1\u003c/li\u003e\n\u003cli\u003eShavazi MA, Selehi ZK. An assessment on the impact of women\u0026apos;s autonomy, education and social participation on childbearing intention in Sirjan city. Woman in Culture and Art (Women\u0026apos;s Research). 2013;11(1):45-64. https://doi.org/10.22059/jwdp.2013.35477\u003c/li\u003e\n\u003cli\u003eZare Z, Kiaetabar R, Laal Ahangar M. Fertility motivations and its related factors in women of reproductive age attended health centers in Sabzevar, Iran. Journal of Midwifery and Reproductive Health. 2019;7(1):1551-9. https://doi.org/10.22038/jmrh.2018.28116.1303\u003c/li\u003e\n\u003cli\u003eFarahani FK. The role of attitude and gender division of labor in women\u0026apos;s fertility preferences and intentions Men of Tehran. Population studies. 2017;5(3,95-125). (Text in Persian)\u003c/li\u003e\n\u003cli\u003eLainiala L. The impact of relationship quality on childbearing in Finland. Finnish Yearbook of Population Research. 2011:31-47.\u003cstrong\u003ehttps://doi.org/10.23979/fypr.45064\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003eRijken AJ, Thomson E. Partners\u0026rsquo; relationship quality and childbearing. Social science research. 2011;40(2):485-97. https://doi.org/10.1016/j.ssresearch.2010.10.001\u003c/li\u003e\n\u003cli\u003eFriedman D, Hechter M, Kanazawa S. A theory of the value of children. Demography. 1994;31(3):375-401.\u003cu\u003e https://doi.org/10.2307/2061749\u003c/u\u003e\u003c/li\u003e\n\u003cli\u003eMohamadi K, Heidari M, Faghihzadeh S. Validity of persian female sexual function index (FSFI). Payesh: J Iranian Instit Health Sci Res. 2008;2(7):269-78. http://payeshjournal.ir/article-1-658-en.html\u003c/li\u003e\n\u003cli\u003eBahrami N, Yaghoob Zadeh A, Sharif Nia H, Soliemani MA, Haghdoost AA. Validity and reliability of the persian version of Larson sexual satisfaction questionnaire in couples. Journal of Kerman University of Medical Sciences. 2016;23(3):344-56. (Text in Persian)\u003c/li\u003e\n\u003cli\u003eHanappi D, Ryser V-A, Bernardi L, Le Goff J-M. Changes in employment uncertainty and the fertility intention\u0026ndash;realization link: An analysis based on the Swiss household panel. European Journal of Population. 2017;33:381-407. https://doi.org/10.1007/s10680-016-9408-y\u003c/li\u003e\n\u003cli\u003eHashemzadeh M, Shariati M, Mohammad Nazari A, Keramat A. Childbearing intention and its associated factors: A systematic review. Nursing open. 2021;8(5):2354-68. \u003cstrong\u003ehttps://doi.org/10.1002/nop2.849\u003c/strong\u003e \u003c/li\u003e\n\u003cli\u003eRijken AJ, Liefbroer AC. The Influence of Partner Relationship Quality on Fertility: L\u0026rsquo;influence de la qualit\u0026eacute; de la relation avec le partenaire sur la f\u0026eacute;condit\u0026eacute;. European Journal of Population/Revue europ\u0026eacute;enne de D\u0026eacute;mographie. 2009;25:27-44. https://doi.org/10.1007/s10680-008-9156-8\u003c/li\u003e\n\u003cli\u003eEsfehani RJ, Kamalimanesh B, Dashti S, Esfehani AJ. Factors Influencing the Decision to Have Child Among Iranian Couples; An Online Survey. https://doi 10.15296/ijwhr.2019.48\u003c/li\u003e\n\u003cli\u003eAzmoude E, Barati-Far S, Behnam H, Aradmehr M. Relationship between gender preference, birth interval and sex composition on fertility behavior. Journal of Torbat Heydariyeh University of Medical Sciences. 2015;3(3):15-8. http://jms.thums.ac.ir/article-1-308-en.html\u003c/li\u003e\n\u003cli\u003eKasiri M. Socio-cultural and Demographic Factors Affecting Fertility \u0026quot;A case study of women aged 15-49 in the city of Varamin, Master\u0026apos;s Degree, university of Tehran, Faculty of social sciences. Tehran, Iran (Text in Persian). 2008.\u003c/li\u003e\n\u003cli\u003eMotlagh ME, Taheri M, Eslami M. Factors affecting the fertility preferences in Iranian ethnic groups. Nursing And Midwifery Journal. 2016;14(6):485-95. http://unmf.umsu.ac.ir/article-1-2845-en.html\u003c/li\u003e\n\u003cli\u003eAbbasi-Shavazi MJ, Mahmoudian H, Sadeghi R, Ghorbani Z. The impact of value-attitude orientations on the ideals of childbearing in Iran. Journal of Population Association of Iran. 2019;13(26):37-66. (Text in Persian)\u003c/li\u003e\n\u003cli\u003eSadeghi H, Saraie H. Effective factors on mothers\u0026rsquo; inclination to have children in tehran hannaneh sadat sadeghi, hasan saraie. Social Development \u0026amp; Welfare Planning. 2016;7(27):1-32. https://doi.org/10.22054/qjsd.2016.5920\u003c/li\u003e\n\u003cli\u003eHaerimehrizi AA, Tavousi M, Sadighi J, Motlagh ME, Eslami M, Naghizadeh F, et al. Reasons for fertility desire and disinterest among Iranian married adults: A population-based study. Payesh (Health Monitor). 2017;16(5):637-45. : http://payeshjournal.ir/article-1-86-en.html\u003c/li\u003e\n\u003cli\u003eOindi FM, Murage A, Lema VM, Mukaindo AM. Association of female sexual dysfunction and fertility: a cross sectional study. Fertility research and practice. 2019;5:1-11. https://doi.org/10.1186/s40738-019-0065-9\u003c/li\u003e\n\u003cli\u003eWitting K, Santtila P, Alanko K, Harlaar N, Jern P, Johansson A, et al. Female sexual function and its associations with number of children, pregnancy, and relationship satisfaction. Journal of Sex \u0026amp; Marital Therapy. 2008;34(2):89-106. https://doi.org/10.1080/00926230701636163\u003c/li\u003e\n\u003cli\u003eBagi M. Prevalence, Reasons and Consequences of Childlessness in the World and Iran: A Systematic Review. Journal of Population Association of Iran. 2023;18(35):97-148. 20.1001.1.20083742.1402.18.35.3.8\u003c/li\u003e\n\u003cli\u003eShreffler KM, Gibbs L, Tiemeyer S, McQuillan J, Greil AL. Is reproductive orientation associated with sexual satisfaction among partnered US women? Archives of sexual behavior. 2021;50(6):2459-69. https://doi.org/10.1007/s10508-021-01984-z\u003c/li\u003e\n\u003cli\u003eAraban M, Karimy M, Armoon B, Zamani-Alavijeh F. Factors related to childbearing intentions among women: a cross-sectional study in health centers, Saveh, Iran. Journal of the Egyptian Public Health Association. 2020;95:1-8. https://doi.org/10.1186/s42506-020-0035-4\u003c/li\u003e\n\u003cli\u003eModiri F, Ghazi Tabatabaie M. A Study on the Effects of the Quality of Marital Life on the Childbearing Intention. Sociology of Social Institutions. 2019;5(12):73-94. https://doi.org/10.22080/ssi.1970.2133 \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 4 are available in the Supplementary Files section.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sexual function, Sexual satisfaction, Childbearing, Fertility","lastPublishedDoi":"10.21203/rs.3.rs-6213354/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6213354/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: childbearing intention is influenced by individual and social factors. Childbearing intention is of particular importance as a unique factor of population growth at the global level. The purpose of this study is to investigate the relationship between sexual function and sexual satisfaction with fertility and childbearing intention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This descriptive study was conducted between May 2023 and July 2024 on 300 married women of reproductive age. In order to collect data, a checklist consisting of demographic characteristics, FSFI Rosen Women's Sexual function Questionnaire, Larson's Sexual Satisfaction Questionnaire, and Rad and savabi Questionnaire were used. Data were analyzed using descriptive statistics (mean, standard deviation, frequency and percentage) by spss software version 21.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Based on the findings, there was a significant relationship between childbearing intention and duration of marriage (P\u0026lt;0.05). In this way, Women who had been married longer were more likely to have children. The results of the Chi-square test showed that there is a significant relationship between average and good sexual function with low childbearing intention, as well as a significant relationship between sexual satisfaction and childbearing intention. (P\u0026lt;0.000)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: According to the results of the study, as sexual satisfaction increases, childbearing intention to increase. There was no significant relationship between sexual function and childbearing intention.\u003c/p\u003e","manuscriptTitle":"title: Sexual function and sexual satisfaction and its association with fertility and childbearing intention ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-09 10:40:49","doi":"10.21203/rs.3.rs-6213354/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"19edf36f-72ad-4fa6-80de-8775f1a03ea0","owner":[],"postedDate":"May 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-05T06:39:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-09 10:40:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6213354","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6213354","identity":"rs-6213354","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}