Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort.

Abstract

To examine the associations between fear of childbirth and emergency caesarean section and between fear of childbirth and dystocia or protracted labour and fetal distress. Prospective cohort study. Danish National Birth Cohort. A total of 25 297 healthy nulliparous women in spontaneous labour with a single fetus in cephalic presentation at term following an uncomplicated pregnancy. Data were collected during 1997-2003 from computer-assisted telephone interviews twice in pregnancy linked with national health registers. Risk for emergency caesarean section of women who feared childbirth; risk for dystocia/protracted labour or fetal distress of women who feared childbirth. Fear of childbirth in early (16 weeks, 6 +/- 29 days) and late (31 weeks, 4 +/- 21 days) pregnancy was associated with emergency caesarean section: OR, 1.23 (1.05-1.47) and 1.32 (1.13-1.55), respectively. When fear of childbirth was expressed at both interviews, the OR was 1.43 (1.13-1.80). Women who feared childbirth had an increased risk for dystocia or protracted labour (OR, 1.33; 1.15-1.54), but not for fetal distress (OR, 0.94; 0.72-1.23). Fear of childbirth during pregnancy was associated with dystocia and emergency caesarean section but not with fetal distress.