Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia.
School of Public Health, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia.
Midwifery. 2024 Dec;139:104191. doi: 10.1016/j.midw.2024.104191. Epub 2024 Sep 23.
Tokophobia is a mild to extreme fear of pregnancy and/or childbirth that may cause a woman to avoid giving birth. It is a common obstetrical problem that affects women's health. Some studies have found that fear of childbirth is common in East African countries. However, there was inconsistency across those studies, and no study was undertaken to report the pooled prevalence of fear of childbirth and its associated factors. As a result, the purpose of this systematic review and meta-analysis is to identify the pooled prevalence of fear of childbirth and its associated factors in Eastern Africa.
We conducted a systematic review and meta-analysis of studies on the prevalence and associated factors of childbirth fear using Pub Med, Hinari, Google Scholar, and East African University archives. Data were extracted using a data extraction format developed in Microsoft Excel, and the analysis was carried out with STATA 14 statistical software. Each article's quality was assessed using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. The Cochrane Q statistics and I test were used to examine heterogeneity between studies. Subgroup analysis was done by country and sample size. To assess publication bias, a funnel plot, and Egger's regression test were used.
This systematic review and meta-analysis included eleven studies. The pooled prevalence of the fear of childbirth among pregnant women in East Africa was 27.86 %. A history of labor and delivery complications (OR = 5.41, 95 %CI = 2.20, 8.63), poor social support (OR = 4.50, 95 %CI = 1.70, 11.92), primiparity (OR = 1.91, 95 %CI = 1.17, 3.12), no ANC follow-up (AOR=2.65, 95 %CI=1.48, 4.74), and unplanned pregnancy (AOR=4.88, 95 %CI=1.23, 19.31) were statistically associated with the fear of childbirth.
The pooled prevalence of fear of childbirth was high. Previous labor and delivery complications, poor social support, primiparity, a lack of antenatal care follow-up, and unplanned pregnancy were all statistically associated with fear of childbirth. To address this, healthcare providers should focus on individualized psychological support for pregnant women who experience tokophobia. Furthermore, encouraging comprehensive antenatal care and strengthening social networks can reduce the fear of childbirth and promote maternal well-being.
恐惧症是一种对怀孕和/或分娩的轻度到极度恐惧，可能导致女性避免分娩。它是一种常见的产科问题，影响妇女的健康。一些研究发现，对分娩的恐惧在东非国家很常见。然而，这些研究结果并不一致，也没有研究报告对分娩恐惧的普遍流行率及其相关因素进行汇总。因此，本系统评价和荟萃分析的目的是确定东非地区分娩恐惧的普遍流行率及其相关因素。
我们使用 Pub Med、Hinari、Google Scholar 和东非大学档案对关于分娩恐惧的患病率和相关因素的研究进行了系统评价和荟萃分析。使用在 Microsoft Excel 中开发的数据提取格式提取数据，并使用 STATA 14 统计软件进行分析。使用 Joanna Briggs 研究所的流行率研究批判性评估工具评估每篇文章的质量。使用 Cochrane Q 统计量和 I 检验检验研究之间的异质性。按国家和样本量进行亚组分析。使用漏斗图和 Egger 回归检验评估发表偏倚。
本系统评价和荟萃分析包括 11 项研究。东非地区孕妇分娩恐惧的总患病率为 27.86%。既往分娩和分娩并发症史（OR=5.41，95%CI=2.20，8.63）、社会支持差（OR=4.50，95%CI=1.70，11.92）、初产妇（OR=1.91，95%CI=1.17，3.12）、无 ANC 随访（AOR=2.65，95%CI=1.48，4.74）和非计划妊娠（AOR=4.88，95%CI=1.23，19.31）与分娩恐惧有统计学关联。
分娩恐惧的总患病率较高。既往分娩和分娩并发症史、社会支持差、初产妇、缺乏产前保健随访和非计划妊娠均与分娩恐惧有统计学关联。为此，医疗保健提供者应专注于为患有恐惧症的孕妇提供个性化的心理支持。此外，鼓励全面的产前保健和加强社会网络可以减少对分娩的恐惧，促进母婴健康。
