Cohort study finds similar rates of severe childbirth fear between assisted and spontaneous conception, indicating prolonged infertility specifically elevates birth anxiety.
Key Points
To compare the prevalence and predictors of severe fear of childbirth and pregnancy-related anxiety between women conceiving via assisted reproduction and those conceiving spontaneously.
Prospective cohort comparing singleton pregnancies from five Finnish assisted reproduction clinics (n = 367, nulliparous 260) with consecutively sampled spontaneous conception controls (n = 379, nulliparous 135) in 1999.
Participants completed the revised Fear-of-Childbirth Questionnaire and the Pregnancy Anxiety Scale at 20 ± 3.2 weeks of gestation, with severe anxiety defined as scores in the 90th percentile or higher.
The frequency of severe fear of childbirth and pregnancy-related anxiety did not differ between the assisted reproduction and spontaneous conception cohorts.
In nulliparous women across cohorts, a relationship duration exceeding 5 years significantly reduced the odds of severe childbirth fear (OR 0.3, 95% CI 0.2–0.7).
Among nulliparous women in the assisted reproduction group, infertility lasting 7 or more years was an independent risk factor for severe childbirth fear (OR 4.4, 95% CI 1.2–16.9).