Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010
Article first published online: 4 FEB 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 8, pages 965–970, July 2014
How to Cite
Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010. BJOG 2014;121:965–970., , , , , .
- Issue published online: 24 JUN 2014
- Article first published online: 4 FEB 2014
- Manuscript Accepted: 14 NOV 2013
- fear of childbirth;
- pregnancy outcome;
- population register;
- socioeconomic status
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.
A cohort study.
The Finnish Medical Birth Register.
All 788 317 singleton births during 1997–2010 in Finland.
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.
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 (<2500 g), small for gestational age babies, preterm birth and low Apgar scores at 1 minute.
High 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.