School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China.
Guoyang County People's Hospital, Anhui, China.
BMC Pregnancy Childbirth. 2024 May 30;24(1):394. doi: 10.1186/s12884-024-06585-x.
Fear of childbirth (FOC) can influence both maternal and child health. Research on FOC in China is scarce, especially on rural women. This study aimed to assess pre- and postpartum FOC and its predictors among Chinese rural women.
This was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed.
The mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001).
The rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women's FOC level and improve their overall pregnancy and childbirth experience.
分娩恐惧（Fear of childbirth，FOC）会影响母婴健康。中国关于 FOC 的研究很少，尤其是针对农村妇女。本研究旨在评估中国农村妇女产前和产后的 FOC 及其预测因素。
这是一项前瞻性相关性研究。共有 569 名妇女在孕晚期完成了产前问卷，其中 477 名妇女在产后三天内完成了产后问卷。调查了产妇的社会人口学信息、临床信息、分娩自我效能感以及产前和产后的 FOC。使用 Wijma 分娩期望/体验问卷（Wijma Childbirth Expectancy/Experience Questionnaire，WDEQ）评估 FOC。进行描述性、双变量、多变量线性回归分析、单变量和多变量逻辑回归分析。
产前和产后 FOC 得分的平均值分别为 64.5（标准差：25.1）和 64.3（标准差：23.9），产前有 20.8%的妇女报告严重恐惧，产后有 18.2%的妇女报告严重恐惧。多变量线性回归分析显示，产前 FOC 水平较高的预测因素包括较高的教育水平、初产妇、较高的月家庭收入、较低的家庭支持和较低的分娩自我效能感（p<0.05），产后 FOC 水平较高的预测因素包括失业状态、较低的分娩自我效能感和较高的产前 FOC（p<0.05）。多变量逻辑回归显示，较高的分娩自我效能感降低了产前严重 FOC 的可能性（OR：0.99，p<0.001），而产前严重 FOC 增加了产后严重 FOC 的可能性（OR：3.57，p<0.001）。
农村妇女在产前和产后都有较高的 FOC，大约 20%的妇女在两个时期都经历了严重的 FOC。较高的教育水平、初产妇、较高的月家庭收入、较低的家庭支持和较低的分娩自我效能感是产前 FOC 升高的预测因素。失业状态、较低的分娩自我效能感和较高的产前 FOC 是产后 FOC 升高的预测因素。值得注意的是，增强分娩自我效能感对于减轻严重的产前 FOC 至关重要，而严重的产前 FOC 显著增加了产后严重 FOC 的可能性。针对上述因素制定有针对性的干预策略，可以帮助降低妇女的 FOC 水平，改善她们的整体妊娠和分娩体验。
