Association persists even after adjustment for parity, counseling, birth weight, maternal age
THURSDAY, June 28 (HealthDay News) -- Women with a fear of childbirth have a significantly increased duration of labor, even after adjusting for multiple confounding variables, according to a study published online June 27 in BJOG: An International Journal of Obstetrics and Gynaecology.
To examine the correlation between fear of childbirth and duration of labor, Samantha S. Adams, M.D., from Akershus University Hospital in Lørenskog, Norway, and colleagues conducted a prospective study involving 2,206 pregnant women with a singleton pregnancy and intended vaginal delivery during 2008 to 2010. The Wijma Delivery Expectancy Questionnaire (W-DEQ) version A was used to evaluate fear of childbirth at 32 weeks of gestation, with fear defined as a W-DEQ sum score ≥85. Maternal ward electronic birth records were used to obtain information on duration of labor, use of epidural, and mode of delivery.
The researchers found that 7.5 percent of women had a fear of childbirth. Labor duration was significantly longer in these women than in controls with no fear (crude unstandardized coefficient, 1.54; corresponding to a difference of one hour and 32 minutes). The difference was still significant but attenuated after adjustment for parity, counseling for pregnancy concern, epidural analgesia, labor induction and augmentation, emergency cesarean delivery, instrumental vaginal delivery, birth weight, and maternal age (adjusted unstandardized coefficient, 0.78; corresponding to a difference of 47 minutes).
"We found a link between fear of childbirth and longer duration of labor. Generally, longer labor duration increases the risk of instrumental vaginal delivery and emergency cesarean section," Adams said in a statement. "However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery and therefore elective cesarean delivery should not be routinely recommended."
Abstract
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