Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997-2010
Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997-2010
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DOI：
10.1111/1471-0528.12599
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发表时间：
2014-07-01
影响因子：
5.8
通讯作者：
Heinonen, S.
中科院分区：
文献类型：
--
作者：
Raisanen, S.;Lehto, S. M.;Heinonen, S.
目的根据胎次和社会经济状况确定分娩恐惧（FOC）的危险因素，并评估FOC与不良围产儿结局之间的关系。设计一项队列研究。芬兰医疗出生登记。1997-2010年芬兰所有788317例单胎出生。方法采用国际疾病分类O99.80对产妇分娩恐惧进行定义，采用多因素Logistic回归分析产妇分娩恐惧与多种危险因素及围生儿结局的关系。主要结果测量FOC的患病率、危险因素和结果。结果2.5%的初产妇和4.5%的经产妇存在分娩恐惧。未产妇FOC最强的危险因素是抑郁症[校正比值比（aOR），6.35; 95%置信区间（CI），5.25-7.68]，高龄产妇（aOR，3.78; 95% CI，3.23-4.42）和高或未指明的社会经济地位。在经产妇女中，FOC最强的危险因素是抑郁（aOR，5.47; 95%CI，4.67-6.41），既往剖宫产（CS）（aOR，3.02; 95%CI，2.93-3.11）和高或未指明的社会经济地位。在未经产和经产妇女中，FOC与CS的发生率较高（分别高3.3倍和4.5倍）和低出生体重的发生率较低（
Objective To identify risk factors for fear of childbirth (FOC) according to parity and socioeconomic status, and to evaluate associations between FOC and adverse perinatal outcomes. Design A cohort study. Setting The Finnish Medical Birth Register. Population All 788317 singleton births during 1997-2010 in Finland. Methods Fear 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 measures Prevalence of, risk factors for and outcomes of FOC. Results Fear 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 (