Chen Junfang, He Liping, Chen Aixiang, Wang Xia, Zhang Zhaodi
Department of Nursing, ChangZhi Medical College, Changzhi, Shanxi, China.
Department of Obstetrics, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
J Reprod Infant Psychol. 2024 Dec 3:1-16. doi: 10.1080/02646838.2024.2435941.
Findings from studies of the influence of fear of childbirth on mode of delivery in women are equivocal. This study used the 2021 Science Database of People Mental Health to investigate the trend of caesarean sections in the Chinese population and its relationship with the fear of childbirth.
A total of 1,894 Chinese women were included in the study. We performed a hierarchical regression analysis to control sociodemographic and obstetric information, depression, anxiety, and fear of childbirth in pregnant women. Restricted cubic spline analysis was applied to determine the association between fear of childbirth and caesarean sections.
The total prevalence of caesarean sections was 54.49%. The final regression analysis explained 58.7% of the variance in the mode of delivery. After controlling for confounders, fear of childbirth was a risk factor for caesarean sections in pregnant women (OR = 1.108, 95% CI: 1.093 ~ 1.124). Furthermore, the RCS analysis showed a non-linear correlation between fear of childbirth and mode of delivery (non-linear < 0.001), and a stronger impact was found in the relation between fear of childbirth and mode of delivery in multiparous women than in primiparous women.
Mild or high-level fear of childbirth during the third trimester was associated with an increased number of caesarean sections, especially in multiparous women. These results suggested that healthcare professionals should underscore the importance of fear of childbirth screening and implement targeted interventions for affected women.
关于分娩恐惧对女性分娩方式影响的研究结果并不明确。本研究利用2021年《中国人群心理健康科学数据库》调查了中国人群剖宫产的趋势及其与分娩恐惧的关系。
本研究共纳入1894名中国女性。我们进行了分层回归分析，以控制孕妇的社会人口学和产科信息、抑郁、焦虑及分娩恐惧。应用受限立方样条分析来确定分娩恐惧与剖宫产之间的关联。
剖宫产的总患病率为54.49%。最终回归分析解释了分娩方式变异的58.7%。在控制混杂因素后，分娩恐惧是孕妇剖宫产的一个危险因素（OR = 1.108，95%CI：1.093～1.124）。此外，受限立方样条分析显示分娩恐惧与分娩方式之间存在非线性相关性（非线性P < 0.001），经产妇分娩恐惧与分娩方式之间的关系比初产妇更强。
孕晚期轻度或高度的分娩恐惧与剖宫产数量增加有关，尤其是经产妇。这些结果表明，医护人员应强调分娩恐惧筛查的重要性，并对受影响的女性实施针对性干预措施。
