BackgroundBetween 5% and 14% of women suffer from fear of childbirth (FOC) which is associated with difficulties during birth and in postnatal psychological adjustment. Therefore, effective interventions are needed to improve outcomes for women. A systematic review and meta-analysis was used to identify effective interventions for treating women with FOC.MethodsLiterature searches were undertaken on online databases. Hand searches of reference lists were also carried out. Studies were included in the review if they recruited women with FOC and aimed to reduce FOC and/or improve birth outcomes. Data were synthesised qualitatively and quantitatively using meta-analysis. The literature searches provided a total of 4474 citations.ResultsAfter removing duplicates and screening through abstracts, titles and full texts, 66 papers from 48 studies were identified for inclusion in the review. Methodological quality was mixed with 30 out of 48 studies having a medium risk of bias. Interventions were categorised into six broad groups: cognitive behavioural therapy, other talking therapies, antenatal education, enhanced midwifery care, alternative interventions and interventions during labour. Results from the meta-analysis showed that most interventions reduced FOC, regardless of the approach (mean effect size = −1.27; z = −4.53, p < 0.0001) and that other talking therapies may reduce caesarean section rates (OR 0.48, 95% CI 0.48–0.90).ConclusionsPoor methodological quality of studies limits conclusions that can be drawn; however, evidence suggests that most interventions investigated reduce FOC. Future high-quality randomised controlled trials are needed so that clear conclusions can be made.

中文翻译：

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治疗妊娠期分娩恐惧的干预措施：系统评价和荟萃分析

背景 5% 至 14% 的女性患有分娩恐惧症 (FOC)，这与分娩过程中的困难和产后心理调整有关。因此，需要有效的干预措施来改善女性的结局。系统回顾和荟萃分析用于确定治疗 FOC 女性的有效干预措施。方法对在线数据库进行文献搜索。还进行了参考列表的手动搜索。如果研究招募患有 FOC 的女性并旨在减少 FOC 和/或改善出生结果，则这些研究被纳入审查。使用荟萃分析对数据进行定性和定量综合。文献检索共提供4474条引文。结果通过摘要、标题和全文去除重复和筛选后，来自 48 项研究的 66 篇论文被确定纳入审查。方法学质量与 48 项研究中的 30 项具有中等偏倚风险混合。干预措施分为六大类：认知行为疗法、其他谈话疗法、产前教育、增强助产护理、替代干预措施和分娩干预。荟萃分析的结果表明，无论采用何种方法，大多数干预措施都会降低 FOC（平均效应大小 = -1.27；z= -4.53,p< 0.0001）并且其他谈话疗法可能会降低剖宫产率（OR 0.48, 95% CI 0.48–0.90）。然而，有证据表明，大多数被调查的干预措施都会降低 FOC。未来需要高质量的随机对照试验，以便得出明确的结论。