School of Public Health, Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China.
Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China.
J Affect Disord. 2024 Feb 15;347:183-191. doi: 10.1016/j.jad.2023.11.054. Epub 2023 Nov 23.
The prevalence and impact of fear of childbirth (FOC) has not been sufficiently understood. We aimed to investigate the prevalence of FOC among Chinese population and its impact on mode of delivery, postpartum mental health and breastfeeding.
We conducted a prospective cohort study, wherein pregnant women in their third trimester who underwent antenatal assessments at Shanghai Changning Maternity and Infant Health Hospital between September 2020 and March 2021 were recruited. Sociodemographic data of the participants were gathered by self-administered questionnaire, and their FOC was assessed using the Wijma Delivery Expectancy Questionnaire. Participants were followed up to 42 days postpartum. Information regarding their modes of delivery was retrieved from medical records, and data regarding postpartum mental health symptoms and one-month postpartum breastfeeding were obtained through self-administered questionnaires.
Among 1287 participants, 461 (35.8 %) had high-level FOC (W-DEQ ≥ 66). Logistic regressions showed that women with high-level of FOC had higher rates of caesarean delivery on maternal request (CDMR) (aOR = 1.55, 95 % CI: 1.00-2.41, p = 0.049), a higher incidence of postpartum mental health symptoms (aOR = 1.68, 95 % CI: 1.09-2.59, p = 0.018), lower rates of one-month postpartum exclusive breastfeeding (aOR = 0.33, 95 % CI: 0.16-0.69, p = 0.003) and mixed feeding (aOR = 0.44, 95 % CI: 0.21-0.91, p = 0.028).
The long-term implications of FOC beyond the immediate postpartum period were not explored in the study.
High-level FOC during the third trimester was associated with increased CDMR and postpartum mental health symptoms and reduced breastfeeding establishment. These results underscore the significance of FOC screening and tailored interventions for affected women.
对分娩恐惧（fear of childbirth，FOC）的流行程度和影响尚未有充分了解。本研究旨在调查中国人群中 FOC 的流行程度及其对分娩方式、产后心理健康和母乳喂养的影响。
我们进行了一项前瞻性队列研究，招募了 2020 年 9 月至 2021 年 3 月期间在上海长宁妇幼保健院进行第三次产前评估的孕妇。通过自填问卷收集参与者的社会人口统计学数据，并使用 Wijma 分娩期望问卷评估其 FOC。对参与者进行了 42 天的随访。从病历中检索其分娩方式的信息，并通过自填问卷获得产后心理健康症状和产后 1 个月母乳喂养的信息。
在 1287 名参与者中，461 名（35.8%）存在高水平的 FOC（W-DEQ≥66）。逻辑回归显示，高水平 FOC 的女性选择剖宫产的比例更高（CDMR）（aOR=1.55，95%CI：1.00-2.41，p=0.049），产后心理健康症状的发生率更高（aOR=1.68，95%CI：1.09-2.59，p=0.018），产后 1 个月纯母乳喂养（aOR=0.33，95%CI：0.16-0.69，p=0.003）和混合喂养（aOR=0.44，95%CI：0.21-0.91，p=0.028）的比例更低。
本研究未探讨 FOC 在产后期间以外的长期影响。
孕晚期高水平的 FOC 与增加的 CDMR 和产后心理健康症状以及母乳喂养建立减少有关。这些结果强调了对受影响妇女进行 FOC 筛查和针对性干预的重要性。
