De Genna Natacha M, Kolko Conlon Rachel P, Spada Meredith, Gopalan Priya
Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St, Pittsburgh, PA, 15261, USA.
BMC Pregnancy Childbirth. 2025 Jul 9;25(1):735. doi: 10.1186/s12884-025-07841-4.
Studies have documented more fear of childbirth (FoC) among younger people, resulting in psychological distress, health-risk behaviors, pregnancy termination, and elective Caesarian delivery. Little is known about FoC in the US, particularly among African Americans, despite higher rates of maternal morbidity and mortality. The purpose of this study is to examine FoC in a US sample of pregnant adolescents and young adults.
We surveyed FoC as part of a prospective cohort study focused on pregnant people ages 14-21 (n = 147). FoC was assessed online during the third trimester using the Revised Wijma Delivery Expectancy/Experience Questionnaire, a measure adapted for the US (alpha = 0.85). We examined the independent contribution of sociodemographic variables, exposure to trauma, mental health, substance use, and social support on FoC scores.
Mean age was 19.7 years (SD = 1.7) and the sample was predominantly African American (76%) and heterosexual (63%). In the final regression model, experiences of child abuse, discrimination, stress, and social support were associated with FoC.
The results of this study highlight pregnancy intentions, experiences of abuse and discrimination, and social support as critically related to FoC among younger patients in the US. Future research is warranted to better understand relationships among these exposures and the potential to address social support to improve pregnancy experiences among young people with FoC. Shifting the focus of care from individual-level attributes associated with health disparities to social determinants of health and contextual factors allows for a health equity-focused population level approach to this vulnerable population.
研究表明，年轻人中对分娩的恐惧（FoC）更为常见，这会导致心理困扰、健康风险行为、终止妊娠和选择性剖宫产。尽管美国孕产妇发病率和死亡率较高，但对于美国的分娩恐惧情况，尤其是非裔美国人中的情况，人们了解甚少。本研究的目的是在美国的怀孕青少年和年轻成年人样本中调查分娩恐惧情况。
作为一项针对14至21岁孕妇（n = 147）的前瞻性队列研究的一部分，我们对分娩恐惧进行了调查。在孕晚期通过在线方式使用修订后的维伊玛分娩期望/体验问卷对分娩恐惧进行评估，该问卷是针对美国情况改编的（α = 0.85）。我们研究了社会人口统计学变量、创伤暴露、心理健康、物质使用和社会支持对分娩恐惧得分的独立影响。
平均年龄为19.7岁（标准差 = 1.7），样本主要为非裔美国人（76%）和异性恋者（63%）。在最终回归模型中，儿童期虐待经历、歧视、压力和社会支持与分娩恐惧有关。
本研究结果强调了怀孕意愿、虐待和歧视经历以及社会支持与美国年轻患者的分娩恐惧密切相关。有必要进行进一步研究，以更好地理解这些暴露因素之间的关系，以及通过解决社会支持来改善有分娩恐惧的年轻人怀孕体验的潜力。将护理重点从与健康差距相关的个体层面属性转移到健康的社会决定因素和背景因素，有助于以健康公平为重点，从人群层面应对这一弱势群体。
