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Iran J Nurs Midwifery Res. 2011 Spring;16(2):169-73.

The association between antenatal anxiety and fear of childbirth in nulliparous women: a prospective study.

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Midwifery Education, Department of Midwifery & Health Reproductive of Tarbiat Modares University, Tehran,, Iran.



This study aimed to examine the association of state and trait anxiety with fear of childbirth to explore whether there was any support for the hypothesis that state and trait anxiety are risk factors for the fear of childbirth or not.


In this prospective study, 156 pregnant women referred to the health centers of Qom. The study samples selected using simple random sampling method. Anxiety and fear of the childbirth in nulliparous women were measured using Spielberger's state-trait anxiety inventory and childbirth attitudes questionnaire (CAQ) at gestational age of 28 and 38 weeks respectively. The data were analyzed using Pearson correlation, t-test, logistic regression and software SPSS(16).


Pearson correlation test indicated a positive and statistically significant association between fear of childbirth scores and state and trait anxiety (p < 0.05). Logistic regression analysis showed that state and trait anxiety at gestational age of week 28(th) increased the risk of fear of childbirth (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.69-4.35) (p = 0.03) ([OR] 2.8, 95% [CI] 1.17-6.80) (p = 0.02) respectively. It also indicated that state and trait anxiety increased the risk of fear of childbirth at gestational age of week 38(th) ([OR] 2.7, 95% [CI] 1.03-6.80) and ([OR] 5.4, 95% [CI] 1.75-16.76) (p = 0.04) (p = 0.003) respectively.


The results support this possibility that state and trait anxiety could be considered as risk factors for the fear of childbirth. Hence, considering other included biological and medical factors, measurement and control of psychological factors in pregnancy is recommended.


Anxiety; childbirth; fear; pregnancy; women


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