Childbirth fear in the USA during the COVID-19 pandemic: key predictors and associated birth outcomes

作者：Zaneta M. Thayer, Suzanna Geisel-Zamora, Glorieuse Uwizeye, Theresa E. Gildner · 发表于：Evolution Medicine and Public Health · 年份：2023 · DOI：10.1093/emph/eoad006 · 被引用次数：14 · 研究领域：Maternal Mental Health During Pregnancy and Postpartum、Maternal and Perinatal Health Interventions、COVID-19 Impact on Reproduction

Abstract Background and objectives Childbirth fear, which has been argued to have an adaptive basis, exists on a spectrum. Pathologically high levels of childbirth fear is a clinical condition called tokophobia. As a chronic stressor in pregnancy, tokophobia could impact birth outcomes. Many factors associated with tokophobia, including inadequate labor support, were exacerbated by the COVID-19 pandemic. Methodology We used longitudinally collected data from a convenience sample of 1775 pregnant persons in the USA to evaluate the association between general and COVID-19 pandemic-related factors and tokophobia using the fear of birth scale. We also assessed associations between tokophobia, low birth weight and preterm birth when adjusting for cesarean section and other covariates among a subset of participants (N = 993). Results Tokophobia was highly prevalent (62%). Mothers who self-identified as Black (odds ratio (OR) = 1.90), had lower income (OR = 1.39), had less education (OR = 1.37), had a high-risk pregnancy (OR = 1.65) or had prenatal depression (OR = 4.95) had significantly higher odds of tokophobia. Concerns about how COVID-19 could negatively affect maternal and infant health and birth experience were also associated with tokophobia (ORs from 1.51 to 1.79). Tokophobia was significantly associated with increased odds of giving birth preterm (OR = 1.93). Conclusions and implications Tokophobia increases the odds of preterm birth and is more prevalent among individuals...