Zhou Juan, Zhu Zhengting, Li Ruoyu, Guo Xiujing, Li Dehua
Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Front Psychol. 2025 Mar 12;16:1530311. doi: 10.3389/fpsyg.2025.1530311. eCollection 2025.
To explore effectiveness of non-pharmacological interventions in fear of childbirth.
All published literature were searched from three databases (Pubmed, Cochrane CENTRAL, and Web of Science) as of April 2024. The risk of bias of the included studies was assessed using the Cochrane Systematic Review Manual 2.0 bias risk assessment tool. The primary outcome was FOC, the secondary outcomes were depression, anxiety, stress, childbirth self-efficacy, and mode of delivery.
This study included 32 randomized controlled trials, involving 17 interventions and 3,187 pregnant women. Compared with usual care, cognitive-behavioral therapy (SMD = -1.62, 95%CI -2.47 to -0.66), haptonomy (SMD = -1.43, 95%CI -2.63 to -0.24), motivational interview (SMD = -1.35, 95%CI -2.35 to -0.35), counseling therapy (SMD = -1.08, 95%CI -1.91 to -0.25) statistically and significantly improved fear of childbirth in gestational period. Emotional freedom technique (SMD = -3.13, 95%CI -5.00 to -1.26), counseling therapy (SMD = -1.81, 95%CI -2.97 to -0.80), haptonomy (SMD = -1.78, 95%CI -2.89 to -0.66), cognitive-behavioral therapy (SMD = -1.42, 95%CI -2.53 to -0.32), motivational interview (SMD = -1.28, 95%CI -2.37 to -0.19) statistically and significantly improved fear of childbirth in postnatal period. The cluster analysis showed that emotional freedom technique, haptonomy, motivational interview, cognitive-behavioral therapy, counseling therapy were considered to be more effective non-pharmacological interventions.
Several non-pharmacological interventions are promising in the daily care of pregnant women with fear of childbirth. Healthcare professionals should be encouraged to apply these non-pharmacological interventions for informal caregivers of pregnant women with fear of childbirth.
https://www.crd.york.ac.uk/PROSPERO, CRD42024536944.
探讨非药物干预措施在分娩恐惧方面的有效性。
检索截至2024年4月的三个数据库（PubMed、Cochrane CENTRAL和Web of Science）中的所有已发表文献。使用Cochrane系统评价手册2.0偏倚风险评估工具评估纳入研究的偏倚风险。主要结局为分娩恐惧，次要结局为抑郁、焦虑、压力、分娩自我效能感和分娩方式。
本研究纳入32项随机对照试验，涉及17种干预措施和3187名孕妇。与常规护理相比，认知行为疗法（标准化均数差[SMD]=-1.62，95%置信区间[-2.47，-0.66]）、触觉疗法（SMD=-1.43，95%置信区间[-2.63，-0.24]）、动机性访谈（SMD=-1.35，95%置信区间[-2.35，-0.35]）、咨询疗法（SMD=-1.08，95%置信区间[-1.91，-0.25]）在统计学上显著改善了孕期的分娩恐惧。情绪释放技术（SMD=-3.13，95%置信区间[-5.00，-1.26]）、咨询疗法（SMD=-1.81，95%置信区间[-2.97，-0.80]）、触觉疗法（SMD=-1.78，95%置信区间[-2.89，-0.66]）、认知行为疗法（SMD=-1.42，95%置信区间[-2.53，-0.32]）、动机性访谈（SMD=-1.28，95%置信区间[-2.37，-0.19]）在统计学上显著改善了产后的分娩恐惧。聚类分析表明，情绪释放技术、触觉疗法、动机性访谈、认知行为疗法、咨询疗法被认为是更有效的非药物干预措施。
几种非药物干预措施在对有分娩恐惧的孕妇的日常护理中很有前景。应鼓励医护人员将这些非药物干预措施应用于有分娩恐惧的孕妇的非正式照护者。
