The Irish Center for Fetal and Neonatal Translational Research (INFANT Center), University College Cork, Cork, Ireland.
Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland.
Acta Obstet Gynecol Scand. 2019 Aug;98(8):1014-1023. doi: 10.1111/aogs.13599. Epub 2019 Mar 20.
There is growing evidence of the considerable impact of fear of childbirth on women's health and well-being, but prevalence reports of high and severe fear of childbirth and reported risk factors have been inconsistent in various studies. Therefore, this study aimed to determine the prevalence of high and severe fear of childbirth, and to identify risk factors of childbirth fear.
A cross-sectional study was conducted among a convenience sample of 882 pregnant women attending antenatal care in Cork, Ireland. Fear of childbirth was assessed using the Wijma Delivery Expectancy Questionnaire version A (W-DEQ A) using a cut-off ≥66 to define high fear and ≥85 to define severe fear. Associated risk factors were investigated using univariate and multivariate multinomial logistic regression analyses. Four W-DEQ A subscales were calculated using a cut-off ≥2.5 to determine the nature of childbirth fear.
Overall prevalence of severe fear of childbirth was 5.3% and high fear of childbirth was 36.7%. The prevalence of severe fear of childbirth was 7.4% in nulliparous women and 4.3% in multiparous women; however, the difference was not statistically significant (P < 0.07). The prevalence of high fear of childbirth was 43% in nulliparous women and 33.6% in multiparous women, and this difference was statistically significant (P < 0.005). High fear of childbirth was associated with single marital status when compared with married or co-habiting women (P < 0.008). In a multivariate analysis, high fear of childbirth was significantly associated with low perceived informational support (adjusted relative risk ratio 2.62, 95% confidence interval [CI] 1.34-5.13) and possible depression (assessed by the Edinburgh Postnatal Depression Scale) (adjusted relative risk ratio 12.87, 95% CI 6.07-27.25). In the W-DEQ A subscales, 35.6% of women scored ≥2.5 in Negative Emotions, 29.4% scored ≥2.5 in Lack of Positive Emotions, 9.9% scored ≥2.5 in Social Isolation and 7.8% scored ≥2.5 in Moment of Birth.
Fear of childbirth is relatively common, with varying severity, and was more common in first-time mothers. Using W-DEQ A subscales provided additional information about the nature of the fear, in addition to severity of fear of childbirth.
越来越多的证据表明，对分娩的恐惧对女性的健康和幸福有很大的影响，但在各种研究中，对分娩恐惧的高发生率和严重程度以及报告的危险因素的报道一直不一致。因此，本研究旨在确定分娩恐惧的高发生率和严重程度，并确定分娩恐惧的危险因素。
本研究采用横断面研究设计，对爱尔兰科克的 882 名参加产前护理的孕妇进行了便利抽样。采用 Wijma 分娩期望问卷 A 版（W-DEQ A），以≥66 定义为高恐惧，≥85 定义为严重恐惧，评估分娩恐惧。采用单变量和多变量多项逻辑回归分析调查相关危险因素。使用≥2.5 的截断值计算四个 W-DEQ A 分量，以确定分娩恐惧的性质。
严重分娩恐惧的总体患病率为 5.3%，高分娩恐惧的患病率为 36.7%。初产妇中严重分娩恐惧的患病率为 7.4%，经产妇中为 4.3%；然而，差异无统计学意义（P<0.07）。初产妇中高分娩恐惧的患病率为 43%，经产妇中为 33.6%，差异有统计学意义（P<0.005）。与已婚或同居妇女相比，单身婚姻状况与高分娩恐惧有关（P<0.008）。在多变量分析中，与信息支持感知低（调整后的相对危险比 2.62，95%置信区间[CI]1.34-5.13）和可能的抑郁（通过爱丁堡产后抑郁量表评估）（调整后的相对危险比 12.87，95%CI6.07-27.25）相关。在 W-DEQ A 分量中，35.6%的妇女在负面情绪上的得分≥2.5，29.4%在缺乏积极情绪上的得分≥2.5，9.9%在社会孤立上的得分≥2.5，7.8%在分娩时刻上的得分≥2.5。
分娩恐惧较为常见，严重程度不一，初产妇中更为常见。使用 W-DEQ A 分量除了评估分娩恐惧的严重程度外，还提供了有关恐惧性质的更多信息。
