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Abstract：
BACKGROUND: Fear of childbirth (FOC) can influence both maternal and child health. Research on FOC in China is scarce, especially on rural women. This study aimed to assess pre- and postpartum FOC and its predictors among Chinese rural women.
METHODS: This was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed.
RESULTS: The mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001).
CONCLUSIONS: The rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women\'s FOC level and improve their overall pregnancy and childbirth experience.
METHODS: This was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed.
RESULTS: The mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001).
CONCLUSIONS: The rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women\'s FOC level and improve their overall pregnancy and childbirth experience.
摘要：
背景：对分娩的恐惧（FOC）会影响母婴健康。中国对FOC的研究很少，尤其是农村妇女。本研究旨在评估中国农村妇女的产前和产后FOC及其预测因素。
方法：这是一项前瞻性相关研究。共有569名妇女在妊娠晚期完成了产前问卷，其中477人在分娩后三天内完成了产后问卷。产妇社会人口统计信息，临床信息，对分娩自我效能和产前、产后FOC进行调查。使用Wijma分娩期望/经验问卷（WDEQ）评估FOC。描述性的,双变量，多元线性回归分析，进行了单因素和多因素logistic回归分析.
结果：平均术前和产后FOC评分分别为64.5（标准差：25.1）和64.3（标准差：23.9），分别,20.8％的妇女在分娩前报告了严重的恐惧，分娩后报告了18.2％。多元线性回归分析显示出产前FOC水平较高的预测因素，包括较高的教育水平，nullipara,每月家庭收入较高，较低的家庭支持，和较低的分娩自我效能（p<0.05）和较高的产后FOC水平的预测因素包括失业状态，较低的分娩自我效能感，产前FOC较高(p<0.05)。多因素logistic回归分析显示，分娩自我效能感较高降低严重产前FOC的可能性（OR：0.99，p<0.001），严重的产前FOC增加了严重的产后FOC的可能性（OR：3.57，p<0.001）。
结论：农村妇女在分娩前后的FOC水平较高，大约20%的人在这两个时期都经历过严重的FOC。高等教育水平,nullipara,每月家庭收入较高，较低的家庭支持，较低的分娩自我效能感是产前FOC升高的预测因素。失业状况,较低的分娩自我效能感，产前FOC升高是产后FOC升高的预测因素。值得注意的是,提高分娩自我效能对于减轻严重的产前FOC至关重要，而严重的产前FOC显着增加了严重的产后FOC的可能性。针对上述因素制定有针对性的干预策略有助于降低女性的FOC水平,改善其整体妊娠和分娩体验。
方法：这是一项前瞻性相关研究。共有569名妇女在妊娠晚期完成了产前问卷，其中477人在分娩后三天内完成了产后问卷。产妇社会人口统计信息，临床信息，对分娩自我效能和产前、产后FOC进行调查。使用Wijma分娩期望/经验问卷（WDEQ）评估FOC。描述性的,双变量，多元线性回归分析，进行了单因素和多因素logistic回归分析.
结果：平均术前和产后FOC评分分别为64.5（标准差：25.1）和64.3（标准差：23.9），分别,20.8％的妇女在分娩前报告了严重的恐惧，分娩后报告了18.2％。多元线性回归分析显示出产前FOC水平较高的预测因素，包括较高的教育水平，nullipara,每月家庭收入较高，较低的家庭支持，和较低的分娩自我效能（p<0.05）和较高的产后FOC水平的预测因素包括失业状态，较低的分娩自我效能感，产前FOC较高(p<0.05)。多因素logistic回归分析显示，分娩自我效能感较高降低严重产前FOC的可能性（OR：0.99，p<0.001），严重的产前FOC增加了严重的产后FOC的可能性（OR：3.57，p<0.001）。
结论：农村妇女在分娩前后的FOC水平较高，大约20%的人在这两个时期都经历过严重的FOC。高等教育水平,nullipara,每月家庭收入较高，较低的家庭支持，较低的分娩自我效能感是产前FOC升高的预测因素。失业状况,较低的分娩自我效能感，产前FOC升高是产后FOC升高的预测因素。值得注意的是,提高分娩自我效能对于减轻严重的产前FOC至关重要，而严重的产前FOC显着增加了严重的产后FOC的可能性。针对上述因素制定有针对性的干预策略有助于降低女性的FOC水平,改善其整体妊娠和分娩体验。
