孕妇分娩恐惧危险因素的Meta分析

Meta-analysis of risk factors of fear of childbirth among pregnant women

目的明确孕妇分娩恐惧的危险因素。方法检索Cochrane Library、CINAHL、PubMed、Embase、Web of Science、PsycINFO、中国知网、万方数据知识服务平台和维普中文科技期刊数据库中有关孕妇分娩恐惧的研究。使用RevMan 5.4软件进行Meta分析。结果共纳入13篇研究。文化程度[OR=3.24,95%CI(1.26,8.30),P=0.010]、经济状况[OR=2.78,95%CI(1.69,4.59),P<0.001]、产前教育[OR=3.14,95%CI(2.27,4.33),P<0.001]、偏好分娩方式[OR=4.28,95%CI(2.56,7.15),P<0.001]、非计划妊娠[OR=5.27,95%CI(2.41,11.52),P<0.001]、妊娠并发症[OR=5.07,95%CI(2.03,12.71),P=0.001]、负面分娩经历[OR=7.98,95%CI(5.57,11.42),P<0.001]、社会支持[OR=2.04,95%CI(1.22,3.41),P=0.007]、焦虑和抑郁[OR=6.77,95%CI(4.72,9.72),P<0.001]是孕妇发生分娩恐惧的危险因素。结论文化程度低、经济状况差、未参加产前教育、偏好剖宫产分娩、非计划妊娠、妊娠并发症、负面分娩经历、社会支持低、焦虑和抑郁是孕妇发生分娩恐惧的危险因素,未来应采取针对性干预措施预防和降低孕妇分娩恐惧的发生。

Objective To clarify the risk factors of fear of childbirth among pregnant women.Methods The data of Cochrane Library,CINAHL,PubMed,Embase,Web of Science,PsycINFO,CNKI,Wanfang and VIP were searched.Using RevMan 5.4 software to Meta-analysis.Results Thirteen studies were included.The risk factors for of fear of childbirth included education level[OR=3.24,95%CI(1.26,8.30),P=0.010],economic status[OR=2.78,95%CI(1.69,4.59),P<0.001],prenatal education[OR=3.14,95%CI(2.27,4.33),P<0.001],preferred delivery mode[OR=4.28,95%CI(2.56,7.15),P<0.001],unexpected pregnancy[OR=5.27,95%CI(2.41,11.52),P<0.001],pregnancy complications[OR=5.07,95%CI(2.03,12.71),P=0.001],negative delivery experience[OR=7.98,95%CI(5.57,11.42),P<0.001],social support[OR=2.04,95%CI(1.22,3.41),P=0.007],and anxiety and depression[OR=6.77,95%CI(4.72,9.72),P<0.001].Conclusion The risk factors for pregnant women's fear of childbirth include low education level,poor economic status,failure to attend prenatal education,preference for cesarean delivery,unplanned pregnancy,pregnancy complications,negative delivery experience,poor social support,and anxiety and depression.In the future,the targeted intervention measures should be taken to prevent and reduce the prevalence of fear of childbirth in pregnant women.