Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Introduction Fear of childbirth (FOC) is a common obstetrical challenge that affects the health of women. The epidemiology of FOC has not been studied in Finland for the last decade. The aim of this study was to analyze the epidemiology and risk factors for FOC and to evaluate the association betwee...

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Published in:Acta obstetricia et gynecologica Scandinavica Vol. 102; no. 4; pp. 430 - 437
Main Authors: Vaajala, Matias, Liukkonen, Rasmus, Kuitunen, Ilari, Ponkilainen, Ville, Mattila, Ville M., Kekki, Maiju
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01.04.2023
John Wiley and Sons Inc
Wiley
Subjects:
Cesarean Section
Cohort analysis
Cohort Studies
delivery
Delivery, Obstetric
Diabetes, Gestational
Epidemiology
Fear
fear of childbirth
Female
Finland
Gestational diabetes
Humans
Medical diagnosis
Original
Parturition
Pregnancy
Regression analysis
Risk factors
Womens health
Finland
delivery
fear of childbirth
cesarean section
ISSN:0001-6349, 1600-0412, 1600-0412
Online Access:Get full text
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Summary:Introduction Fear of childbirth (FOC) is a common obstetrical challenge that affects the health of women. The epidemiology of FOC has not been studied in Finland for the last decade. The aim of this study was to analyze the epidemiology and risk factors for FOC and to evaluate the association between FOC and the rate of elective cesarean section (CS) as an intended mode of delivery. Material and methods Data from the National Medical Birth Register were used to evaluate the epidemiology of FOC and to determine the main risk factors for FOC in Finland between 2004 and 2018. Nulliparous and multiparous women were analyzed separately. Logistic regression model was used to determine the main risk factors for FOC. Multivariable logistic regression model was used to assess the intended mode of delivery in those pregnancies with diagnosed maternal FOC. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were calculated. Results A total of 1 million pregnancies were included. The annual rate of pregnancies with maternal FOC increased from 1.5% (CI: 1.4–1.6) in 2004 to 9.1% (CI: 8.7–9.3) in 2018 for all women. For nulliparous women, the rate increased from 1.1% (CI: 1.0–1.3) in 2004 to 7.1% (CI: 6.7–7.5) in 2018, and from 1.8% (CI: 1.7–2.0) in 2004 to 10.3% (10.0–10.7) in 2018 for multiparous women. The strongest risk factors for maternal FOC were higher maternal age and gestational diabetes. For multiparous women, the strongest risk factors were gestational diabetes and previous CS. The total odds for elective CS were notably higher among women with FOC (aOR 8.63, CI: 8.39–8.88). Conclusions The incidence of maternal FOC rose six‐fold during our study period. However, the numbers of elective CS among women with this diagnosis, which had earlier risen in parallel, leveled off in 2014. The rates of diagnosed maternal fear of birth increased radically during year 2004–2018. Moreover, even though the numbers and rates of women with fear of birth diagnoses increased, the rates for elective cesarean section among women with fear of birth diagnosis decreased strongly during the study period.
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ISSN:0001-6349
1600-0412
1600-0412
DOI:10.1111/aogs.14521