Hendrix Yvette M G A, Baas Melanie A M, Vanhommerig Joost W, de Jongh Ad, Van Pampus Maria G
Department of Obstetrics and Gynecology, OLVG, Amsterdam, Netherlands.
Department of Obstetrics and Gynecology, Martini Hospital, Groningen, Netherlands.
Front Psychol. 2022 Jul 12;13:923819. doi: 10.3389/fpsyg.2022.923819. eCollection 2022.
The relation between fear of childbirth (FoC) and gestational age is inconclusive, and self-reported need for help regarding this fear has never been investigated. This study aimed to determine the prevalence and course of FoC according to gestational age, to identify risk factors for the development of FoC, the influence of this fear on preferred mode of delivery, and self-reported need for help.
Nulliparous pregnant women of all gestational ages completed an online survey. The study consisted of a cross-sectional and a longitudinal analysis. Women who completed the survey in the first or second trimester (T) were approached again in their third trimester (T). The Wijma Delivery Expectancy Questionnaire Version A (W-DEQ A) was used with a cut-off score ≥ 85 to define presence of fear of childbirth. Questionnaires indexing social support, anxiety, symptoms of depression, preferred mode of delivery, and self-reported need for help were included.
In total, 364 women were enrolled at T, and 118 out of 184 eligible women were included in the longitudinal analysis. Point prevalence of FoC at T was 18.4% with no significant difference between trimesters. In the longitudinal sample, the prevalence of FoC decreased from 18.6% (T) to 11.0% (T), = 0.004. Although mean scores for FoC decreased significantly, < 0.001, scores increased in 41 (34.7%) women. The presence of FoC was associated with elevated anxiety, less family support, prenatal care of the obstetrician by choice, preference for a cesarean section, and for pain relief. Women with FoC were more likely to actively seek for help compared to women without FoC.
While FoC is common in each trimester, prevalence decreases over the course of pregnancy. Women with FoC are often actively seeking for help, suggesting that this fear should be addressed better, and help should be offered accordingly.
分娩恐惧（FoC）与孕周之间的关系尚无定论，且从未对关于这种恐惧的自我报告的求助需求进行过调查。本研究旨在根据孕周确定FoC的患病率和病程，识别FoC发生的危险因素、这种恐惧对首选分娩方式的影响以及自我报告的求助需求。
所有孕周的初产妇完成了一项在线调查。该研究包括横断面分析和纵向分析。在孕早期或孕中期（T1）完成调查的女性在孕晚期（T2）再次接受调查。使用Wijma分娩期望问卷A版（W-DEQ A），以≥85的临界值来定义分娩恐惧的存在。纳入了索引社会支持、焦虑、抑郁症状、首选分娩方式和自我报告的求助需求的问卷。
总共364名女性在T1时入组，184名符合条件的女性中有118名纳入纵向分析。T1时FoC的时点患病率为18.4%，各孕期之间无显著差异。在纵向样本中，FoC的患病率从18.6%（T1）降至11.0%（T2），P = 0.004。虽然FoC的平均得分显著下降，P < 0.001，但41名（34.7%）女性的得分有所上升。FoC的存在与焦虑升高、家庭支持较少、选择产科医生进行产前护理、偏好剖宫产以及疼痛缓解有关。与无FoC的女性相比，有FoC的女性更有可能积极寻求帮助。
虽然FoC在每个孕期都很常见，但患病率在孕期过程中会降低。有FoC的女性通常会积极寻求帮助，这表明这种恐惧应得到更好的处理，并应相应地提供帮助。
