Étude de l’anxiété liée à la grossesse et de la peur d’accouchement et de leurs facteurs associés

Abstract

Pregnancy and childbirth are periods of major transition characterized by physical, biological, and psychological disruptions that can affect women's mental health. Women are particularly vulnerable to a large variety of anxiety disorders such as tocophobia and pregnancy-related anxiety. Our study aimed to assess the intensity of pregnancy-related anxiety and fear of childbirth during the 3rd trimester of pregnancy, to identify associated factors, and to investigate the relationship between pregnancy-related anxiety, fear of childbirth, marital satisfaction, and social support. Our study was carried on in the gynecology and obstetrics department of the Hedi Chaker Hospital in Sfax – Tunisia from 22 February 2023 to 31 July 2023. To assess pregnancy-related anxiety and fear of childbirth, we used the Pregnancy-related anxiety questionnaire and the Fear of Childbirth Scale, respectively. Social support and marital satisfaction were assessed using the Social Provisions Scale and the Azrin Scale. We enrolled 350 women with a mean age of 29.3 years. In 53.7% of cases, they had not completed secondary school and in 60.9% of cases, they were housewives. In the assessment of marital satisfaction based on the AZRIN score, 38.8% of women had good marital satisfaction (score above 6), 20.9% had poor satisfaction (score below 5) and 40.3% had average satisfaction (score between 5 and 6). Social support scores ranged from 14 to 40, with an average of 30.22 and a standard deviation of 4.66. The mean score for anxiety related to pregnancy was 31.24 and 48.7 for fear of childbirth. Pregnancy-related anxiety and fear of childbirth were positively and strongly correlated. In multivariate analysis, the independent factors associated with pregnancy-related anxiety and fear of childbirth were a negative experience during the last childbirth, episiotomy, lack of information before episiotomy, and intense sympathetic signs. Sufficient psychological support from the health care team was a protective factor against the fear of childbirth. Marital satisfaction and perceived social support were weakly and negatively correlated with pregnancy-related anxiety and fear of childbirth. Birth preparation and marital and social support are the cornerstones of a pregnant woman's well-being.