Phunyammalee Matus, Buayaem Tirawan, Boriboonhirunsarn Dittakarn
a Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
J Obstet Gynaecol. 2019 Aug;39(6):763-767. doi: 10.1080/01443615.2019.1584885. Epub 2019 Apr 22.
The aims of this study were to determine prevalence of childbirth fear among uncomplicated pregnant women in Siriraj Hospital and possible associated factors. A total of 305 uncomplicated, singleton pregnant women were enrolled during early third trimester. All participants were interviewed regarding baseline demographic, social, economic, family, and obstetric characteristics. Fear of childbirth (FOC) was evaluated by Thai version of Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ). W-DEQ scores and level of FOC were compared between various characteristics to determine possible associated factors. Mean W-DEQ score was 51.9. Prevalence of low, moderate, high, and severe FOC were 18.4%, 64.9%, 16.1%, and 0.7%, respectively. Mean FOC score was significantly higher in women with unplanned than planned pregnancy ( = .033). Women with high to severe FOC were significantly less likely to have adequate income ( = .03), have family support ( = .02), have been told about delivery ( = .03), and have witnessed delivery ( = .01). IMPACT STATEMENT Prevalence of fear of childbirth (FOC) in Western countries varies from 8 to 27%. FOC have been related to several unwanted conditions, including obstetrics complications, operative vaginal delivery, increased analgesic use in labour, elective caesarean section, postpartum depression, and impaired maternal-infant relation. Several factors related to FOC have been reported, including maternal age, parity, gestational age, history of a vacuum or forceps extraction, previous caesarean section, previous adverse perinatal outcome, low education, low socio-economic level, psychiatric problems, personality, lack of social support, and low self-esteem. Prevalence of low, moderate, high, and severe FOC in Siriraj Hospital were 18.4%, 64.9%, 16.1%, and 0.7%, respectively. This was relatively lower than those reported from Western countries. Mean FOC score was significantly higher in women with unplanned than planned pregnancy. High to severe FOC was significantly related to low financial and family support and less understandings on delivery process. Differences in the results might be partly due to the differences in study population characteristics of Thais, including ethnics, religions, beliefs, perceptions, social structures, and social norms. Future researches are suggested to explore and understand more about social and cultural factors associated with FOC. Identification of women with high or severe degree of FOC could help in preparing the women at risk before or during pregnancy to lessen FOC in order to improve their childbirth experiences. In addition, effective interventions to reduce FOC should be developed, evaluated, and implemented in the future.
本研究的目的是确定诗里拉吉医院无并发症孕妇的分娩恐惧患病率及可能的相关因素。在孕晚期早期共纳入了305名单胎无并发症孕妇。所有参与者均接受了关于基线人口统计学、社会、经济、家庭和产科特征的访谈。采用泰国版的维伊玛分娩预期/体验问卷A版（W-DEQ）评估分娩恐惧（FOC）。比较不同特征之间的W-DEQ得分和FOC水平，以确定可能的相关因素。W-DEQ平均得分为51.9。低、中、高和严重FOC的患病率分别为18.4%、64.9%、16.1%和0.7%。意外怀孕女性的平均FOC得分显著高于计划怀孕女性（P = 0.033）。FOC为高至严重的女性收入充足的可能性显著较低（P = 0.03），获得家庭支持的可能性显著较低（P = 0.02），被告知分娩相关情况的可能性显著较低（P = 0.03），以及目睹过分娩过程的可能性显著较低（P = 0.01）。影响声明 西方国家的分娩恐惧（FOC）患病率在8%至27%之间。FOC与多种不良情况相关，包括产科并发症、阴道助产、分娩时镇痛药使用增加、择期剖宫产、产后抑郁以及母婴关系受损。已报道了一些与FOC相关的因素，包括产妇年龄、产次、孕周、真空吸引或产钳助产史、既往剖宫产史、既往不良围产期结局、低教育水平、低社会经济水平、精神问题、个性、缺乏社会支持以及低自尊。诗里拉吉医院低、中、高和严重FOC的患病率分别为18.4%、64.9%、16.1%和0.7%。这相对低于西方国家报道的患病率。意外怀孕女性的平均FOC得分显著高于计划怀孕女性。高至严重FOC与低经济和家庭支持以及对分娩过程了解较少显著相关。结果的差异可能部分归因于泰国人研究人群特征的差异，包括种族、宗教、信仰、观念、社会结构和社会规范。建议未来的研究进一步探索和了解与FOC相关的社会和文化因素。识别FOC程度高或严重的女性有助于在怀孕前或怀孕期间为有风险的女性做好准备，以减轻FOC，从而改善她们的分娩体验。此外，未来应开发、评估和实施有效的干预措施以降低FOC。
