Azizi Marzieh, Kamali Mahsa, Elyasi Forouzan, Shirzad Mahboobeh
Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Boali-Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Int J Reprod Biomed. 2021 Jun 23;19(5):401-420. doi: 10.18502/ijrm.v19i5.9250. eCollection 2021 May.
Due to the fear of childbirth (FOC) and failure to provide painless delivery in Iran, the prevalence rate of elective cesarean section (C-section) performed on request by pregnant women is on the rise. However, no systematic review assessing the results of studies in this respect has been thus far developed.
To systematically review published psychological intervention research reflecting on FOC in Iran.
In this systematic review, the databases of PubMed, MEDLINE, PsycINFO, Wiley, ISI Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, and Scientific Information Database were searched to retrieve the relevant studies. Manual searches were performed to find the relevant articles and finally 21 intervention studies were reviewed.
Based on the modified Jadad Scale, a methodological quality (risk of bias) assessment tool, 14 and 7 studies had acceptable or good and low quality, respectively. The included articles covered fear, fear of childbirth, pregnancy, and psychological intervention in Iran. Cognitive behavioral therapy, relaxation techniques, psychological counseling, childbirth preparation classes (CPCs), mindfulness programs, and psychoeducation had been also practiced as the main types of psychological interventions for reducing FOC in pregnant women.
There was no clear evidence to establish the most effective method for minimizing levels of FOC in pregnant women. Based on the assessment tool and since most of the studies had moderate or low quality, conducting standard and high-quality randomized controlled trials focusing on FOC in pregnant women is of most importance in Iranian population.
由于伊朗存在分娩恐惧（FOC）且未能提供无痛分娩服务，孕妇要求进行的选择性剖宫产（C -section）的患病率正在上升。然而，迄今为止尚未开展评估这方面研究结果的系统评价。
系统评价伊朗已发表的关于分娩恐惧的心理干预研究。
在本系统评价中，检索了 PubMed、MEDLINE、PsycINFO、Wiley、ISI 科学网、Scopus、Science Direct、Cochrane 图书馆、谷歌学术和科学信息数据库等数据库，以检索相关研究。进行了手工检索以查找相关文章，最终对 21 项干预研究进行了综述。
基于改良的 Jadad 量表（一种方法学质量（偏倚风险）评估工具），分别有 14 项和 7 项研究质量可接受或良好以及质量较低。纳入的文章涵盖了伊朗的恐惧、分娩恐惧、妊娠和心理干预。认知行为疗法、放松技巧、心理咨询、分娩准备课程（CPCs）、正念计划和心理教育也被用作减轻孕妇分娩恐惧的主要心理干预类型。
没有明确证据表明存在将孕妇分娩恐惧水平降至最低的最有效方法。基于评估工具，且由于大多数研究质量中等或较低，开展针对伊朗人群孕妇分娩恐惧的标准和高质量随机对照试验至关重要。
