Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis

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O'Connell, Maeve A.
Leahy-Warren, Patricia
Khashan, Ali S.
Kenny, Louise C.
O'Neill, Sinéad M.
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Introduction: Tocophobia is defined as a severe fear of pregnancy and childbirth. There is increasing evidence that tocophobia may have short-term and long-term adverse effects on mother and baby. We performed a systematic review and meta-analysis to determine the global prevalence of tocophobia in pregnancy. Material and methods: Relevant articles were identified through searching six relevant databases: MEDLINE, CINAHL, Pubmed, PsycINFO, Maternity & Infant Care and Scopus between 1946 and April 2016. We used search terms for tocophobia prevalence in pregnant women that we agreed with a medical librarian. There were no language restrictions. Two review authors independently assessed data for inclusion, extracted data and assessed quality using a standardized appraisal tool. Meta-analysis was performed to determine the overall pooled-prevalence of tocophobia. Several subgroup and sensitivity analyses were conducted. Results: Thirty-three studies were included in the systematic review from 18 countries of which data from 29 studies were used in the meta-analysis of 853 988 pregnant women. Definition of tocophobia varied, whereas prevalence rates ranged between 3.7 and 43%. The overall pooled prevalence of tocophobia, using a random-effects model, was 14% (95% CI 0.12â 0.16). Significant heterogeneity was observed (I2 = 99.25%, p = 0.00), which was not explained in subgroup analyses including tocophobia definition used, screening trimester and parity. Conclusion: The prevalence of tocophobia is estimated at 14% and appears to have increased in recent years (2000 onwards). Considerable heterogeneity (99.25%) was noted that may be attributed to lack of consensus on the definition of tocophobia, so our results should be interpreted with caution.
Epidemiology , Fear of childbirth , Pregnancy , Systematic review , Tocophobia , W-DEQ A
O'Connell, M. A., Leahy-Warren, P., Khashan, A. S., Kenny, L. C. and O'Neill, S. M. 'Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis', Acta Obstetricia et Gynecologica Scandinavica, doi:10.1111/aogs.13138 In Press
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© 2017 Nordic Federation of Societies of Obstetrics and Gynecology. This is the peer reviewed version of the following article: Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis. Acta Obstet Gynecol Scand 2017, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.