The influence of maternal psychological distress on the mode of birth and duration of labor: findings from the FinnBrain Birth Cohort Study.

Content Provider	Europe PMC
Author	Sanni, Kuuri-Riutta Eeva, Ekholm Noora, Scheinin M. Laura, Korhonen S. Linnea, Karlsson Hasse, Karlsson
Abstract	Antepartum depression, general anxiety symptoms, and pregnancy-related anxiety have been recognized to affect pregnancy outcomes. Systematic reviews on these associations lack consistent findings, which is why further research is required. We examined the associations between psychological distress, mode of birth, epidural analgesia, and duration of labor. Data from 3619 women with singleton pregnancies, from the population-based FinnBrain Birth Cohort Study were analyzed. Maternal psychological distress was measured during pregnancy at 24 and 34 weeks, using the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) and its subscale “Fear of Giving Birth” (FOC), the anxiety subscale of the Symptom Checklist-90 (SCL-90) and the Edinburgh Postnatal Depression Scale (EPDS). Mode of birth, epidural analgesia, and labor duration were obtained from the Finnish Medical Birth Register. Maternal psychological distress, when captured with PRAQ-R2, FOC, and SCL-90, increased the likelihood of women having an elective cesarean section (OR: 1.04, 95% CI 1.01–1.06, p = .003; OR: 1.13, 95% CI 1.07–1.20, p < .001; OR: 1.06, 95% CI 1.03–1.10, p = .001), but no association was detected for instrumental delivery or emergency cesarean section. A rise in both the PRAQ-R2, and FOC measurements increased the likelihood of an epidural analgesia (OR: 1.02, 95% CI 1.01–1.03, p = .003; OR: 1.09, 95% CI 1.05–1.12, p < .001) and predicted longer second stage of labor (OR: 1.01, 95% CI 1.00–1.01, p = .023; OR: 1.03, 95% CI 1.02–1.05, p < .001). EPDS did not predict any of the analyzed outcomes. The results indicate that maternal anxiety symptoms (measured using PRAQ-R2, FOC, and SCL-90) are associated with elective cesarean section. Psychological distress increases the use of epidural analgesia, but is not associated with complicated vaginal birth.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00737-022-01212-0.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8921080&blobtype=pdf
ISSN	14341816
Journal	Archives of Women's Mental Health [Arch Womens Ment Health]
Volume Number	25
DOI	10.1007/s00737-022-01212-0
PubMed Central reference number	PMC8921080
Issue Number	2
PubMed reference number	35150311
e-ISSN	14351102
Language	English
Publisher	Springer Vienna
Publisher Date	2022-02-12
Publisher Place	Vienna
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2022
Subject Keyword	Maternal psychological distress Fear of childbirth Mode of birth
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health Obstetrics and Gynecology