Junge Carolin, von Soest Tilmann, Weidner Kerstin, Seidler Andreas, Eberhard-Gran Malin, Garthus-Niegel Susan
Norwegian Institute of Public Health, Oslo, Norway.
Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Birth. 2018 Dec;45(4):469-477. doi: 10.1111/birt.12349. Epub 2018 Apr 6.
This prospective study aims to investigate whether severe fear of childbirth increases pain perceptions during birth and whether co-occurring maternal health and birth factors as well as length and weight of the child explain the association.
The study sample comprised women with a vaginal delivery and was drawn from the Akershus Birth Cohort. Data from the hospital birth's record and questionnaires at weeks 17-19 and 32 of pregnancy and 8 weeks postpartum were used (n = 1649). Analysis of variance and analysis of covariance were conducted to examine whether ratings of labor pain differed significantly between women with and without severe fear of childbirth and which factors explained the difference.
Women with severe fear of childbirth experienced significantly more labor pain than women without severe fear of childbirth (P < .01). However, when controlling for symptoms of maternal depression and anxiety, use of epidural/spinal anesthetic or nitrous oxide gas, and menstrual pain, this difference was no longer significant (P = .09).
Although the results show that labor pain is related to multiple physiological and psychological factors in a complex manner, symptoms of maternal depression and anxiety seem to play a central role for the experience of labor pain, and should therefore be focused on by health practitioners.
这项前瞻性研究旨在调查严重的分娩恐惧是否会增加分娩时的疼痛感知，以及同时存在的产妇健康和分娩因素以及孩子的身长和体重是否能解释这种关联。
研究样本包括经阴道分娩的女性，取自阿克什胡斯出生队列。使用了医院分娩记录以及妊娠第17 - 19周、32周和产后8周时的问卷调查数据（n = 1649）。进行方差分析和协方差分析，以检验有和没有严重分娩恐惧的女性之间的产痛评分是否存在显著差异，以及哪些因素可以解释这种差异。
有严重分娩恐惧的女性比没有严重分娩恐惧的女性经历的产痛明显更多（P <.01）。然而，在控制了产妇抑郁和焦虑症状、硬膜外/脊髓麻醉或一氧化二氮的使用以及痛经后，这种差异不再显著（P =.09）。
尽管结果表明产痛以复杂的方式与多种生理和心理因素相关，但产妇抑郁和焦虑症状似乎在产痛体验中起着核心作用，因此健康从业者应予以关注。
