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Mental disorders and fear of childbirth : a cohort study of women in an inner-city maternity service
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Nath, S., Lewis, L. N., Bick, Debra, Demilew, J. and Howard, L. M. (2021) Mental disorders and fear of childbirth : a cohort study of women in an inner-city maternity service. Birth, 48 (2). pp. 230-241. doi:10.1111/birt.12532
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Official URL: https://doi.org/10.1111/birt.12532
Abstract
Objectives
To estimate the population prevalence of severe fear of childbirth (FOC) during pregnancy and investigate its association with: (a) antenatal common mental disorders (depression and anxiety disorder) and (b) elective cesarean birth.
Methods
545 participants from an inner‐city London maternity population were interviewed soon after their first antenatal appointment (mean gestation: 14 weeks). Current mental disorders were assessed using the Structured Clinical Interview DSM‐IV. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ‐A) at approximately 28 weeks gestation (n = 377), with severe FOC defined using a cutoff of WDEQ‐A ≥ 85. Birth mode information was collected at 3 months post‐delivery using an adapted Adult Service Use Schedule. Linear regressions were used to model associations, adjusting for the effects of covariates (age, parity, relationship status, education, and planned pregnancy). Sampling weights were used to adjust for bias introduced by the stratified sampling. We also accounted for missing data within the analysis.
Results
The estimated population prevalence of severe FOC was 3% (95% CI: 2%‐6%) (n = 377). Depression and anxiety were significantly associated with severe FOC after adjustment for covariates (45% vs 11%; coefficient: 15.75, 95% CI: 8.08‐23.42, P < .001). There was a weak association between severe FOC and elective cesarean birth.
Conclusions
Severe FOC occurs in around 3% of the population. Depression and anxiety are associated with FOC. Pregnant people with depression and anxiety may be at increased risk of experiencing severe FOC. Attitudes toward childbirth should be assessed as part of routine clinical assessment of pregnant people in contact with mental health services.
| Item Type: | Journal Article | ||||||||||||||||||
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| Subjects: | H Social Sciences > HQ The family. Marriage. Woman R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Childbirth -- Psychological aspects, Pregnancy -- Psychological aspects, Motherhood -- Psychological aspects, Pregnant women -- Mental health | ||||||||||||||||||
| Journal or Publication Title: | Birth | ||||||||||||||||||
| Publisher: | Wiley-Blackwell Publishing, Inc. | ||||||||||||||||||
| ISSN: | 0730-7659 | ||||||||||||||||||
| Official Date: | June 2021 | ||||||||||||||||||
| Dates: |
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| Volume: | 48 | ||||||||||||||||||
| Number: | 2 | ||||||||||||||||||
| Page Range: | pp. 230-241 | ||||||||||||||||||
| DOI: | 10.1111/birt.12532 | ||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||
| Reuse Statement (publisher, data, author rights): | "This is the peer reviewed version of the following article: Nath, S, Lewis, LN, Bick, D, Demilew, J, Howard, LM. Mental health problems and fear of childbirth: A cohort study of women in an inner‐city maternity service. Birth. 2021; 00: 1– 12., which has been published in final form at https://doi.org/10.1111/birt.12532. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." | ||||||||||||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||
| RIOXX Funder/Project Grant: |
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