Fear of childbirth in nulliparous and multiparous women: a population‐based analysis of all singleton births in <scp>F</scp>inland in 1997–2010

BJOG: An International Journal of Obstetrics and Gynaecology - Tập 121 Số 8 - Trang 965-970 - 2014
Sari Räisänen1, Soili M. Lehto2,3, Henriette Svarre Nielsen4, Mika Gissler5,6, Michael R. Kramer7, Seppo Heinonen1,3
1Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland
2Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
3School of Medicine, University of Eastern Finland, Kuopio, Finland
4Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
5National Institute for Health and Welfare (THL), Helsinki, Finland
6Nordic School of Public Health, Gothenburg, Sweden
7Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

Tóm tắt

ObjectiveTo identify risk factors for fear of childbirth (FOC) according to parity and socioeconomic status, and to evaluate associations between FOC and adverse perinatal outcomes.DesignA cohort study.SettingThe Finnish Medical Birth Register.PopulationAll 788 317 singleton births during 1997–2010 in Finland.MethodsFear of childbirth was defined according to the International Classification of Diseases code O99.80, and its associations with several risk factors and perinatal outcomes were analysed by multivariable logistic regression.Main outcome measuresPrevalence of, risk factors for and outcomes of FOC.ResultsFear of childbirth was experienced by 2.5% of nulliparous women and 4.5% of multiparous women. The strongest risk factors for FOC in nulliparous women were depression [adjusted odds ratio (aOR), 6.35; 95% confidence interval (CI), 5.25–7.68], advanced maternal age (aOR, 3.78; 95% CI, 3.23–4.42) and high or unspecified socioeconomic status. In multiparous women, the strongest risk factors for FOC were depression (aOR, 5.47; 95% CI, 4.67–6.41), previous caesarean section (CS) (aOR, 3.02; 95% CI, 2.93–3.11) and high or unspecified socioeconomic status. Among both nulliparous and multiparous women, FOC was associated with higher rates of CS (3.3‐fold and 4.5‐fold higher, respectively) and a lower incidence of low birthweight (<2500 g), small for gestational age babies, preterm birth and low Apgar scores at 1 minute.ConclusionsHigh and unspecified socioeconomic status, advanced maternal age and depression are predisposing factors for FOC regardless of parity. Among multiparous women, a previous CS increases vulnerability to FOC. FOC is associated with increased rates of CS, but does not adversely affect other pregnancy outcomes.

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BJOG: An International Journal of Obstetrics and Gynaecology

Tập 121 Số 8

965-970

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