BackgroundMaternal fear of childbirth fluctuates throughout pregnancy. However, no studies have investigated the changing characteristics and influencing factors of fear of childbirth.AimsThis study aimed to identify the trajectory patterns of fear of childbirth in third‐trimester primiparas and to examine the factors influencing these patterns.MethodsThis study followed the STROBE checklist for observational research. A prospective longitudinal design was employed, using the Intolerance of Uncertainty Scale, Childbirth Self‐Efficacy Inventory and Childbirth Attitudes Questionnaire as primary measures. Data were collected from 226 primiparous women at 28–29 weeks, 32–33 weeks, 36–37 weeks and 39–41 weeks of gestation. Growth mixture modelling (GMM) was fitted using Mplus 8.3 software to analyse the trajectory of fear of childbirth. Logistic regression was conducted to identify the factors influencing these trajectories.ResultsThe results revealed heterogeneity in the trajectory of fear of childbirth, which could be categorised into six groups: a normal group without fear, a group with no initial fear but increased fear later, a group with mild fear that decreased, a group with mild fear that worsened, a mild fear stable group and a moderate fear stable group. Logistic regression showed that intolerance of uncertainty, childbirth self‐efficacy and childbirth preference were the primary factors influencing these trajectories (p < 0.05).ConclusionsThis study highlights the varying trajectories of fear of childbirth in third‐trimester primiparas. Different categories of fear emerge, each following a distinct path of change. Healthcare providers can use this information to create individualised interventions, addressing specific concerns and influencing factors at various stages, to support the psychological well‐being of primiparas during the perinatal period.Implications for the Profession and/or Patient CareHealthcare providers should be vigilant about primiparas' awareness of and response to childbirth fear. This study shows that the fear of childbirth often begins to increase or decrease between 32 and 33 weeks of gestation. Screening and interventions should thus be initiated during this period, with follow‐up mechanisms in place. Providers should also assess primiparas' capacity to cope with childbirth fear, offering targeted guidance and education to reduce uncertainty, enhance childbirth self‐efficacy and ultimately alleviate fear.Patient or Public ContributionNo patient or public contribution.Impact StatementThis study is of great interest to health care providers, suggesting that health care providers should be vigilant about primiparas' awareness of and response to childbirth fear. This study shows that the fear of childbirth often begins to increase or decrease between 32 and 33 weeks of gestation. Screening and interventions should thus be initiated during this period, with follow‐up mechanisms in place. Providers should also assess primiparas' capacity to cope with childbirth fear, offering targeted guidance and education to reduce uncertainty, enhance childbirth self‐efficacy and ultimately alleviate fear.

中文翻译：

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孕晚期初产妇害怕分娩的轨迹及影响因素：一项前瞻性纵向研究


背景产妇对分娩的恐惧在整个怀孕期间波动。然而，尚无研究调查对分娩恐惧的变化特征和影响因素。目的本研究旨在确定孕晚期初产妇对分娩恐惧的轨迹模式，并检查影响这些模式的因素。方法本研究遵循 STROBE 观察性研究清单。采用前瞻性纵向设计，使用不确定性不耐受量表、分娩自我效能量表和分娩态度问卷作为主要措施。从 226 名妊娠 28-29 周、32-33 周、36-37 周和 39-41 周的初产妇中收集数据。使用 Mplus 8.3 软件拟合生长混合模型 （GMM） 以分析对分娩恐惧的轨迹。进行 Logistic 回归以确定影响这些轨迹的因素。结果结果揭示了对分娩恐惧轨迹的异质性，可分为六组：正常组无恐惧、最初没有恐惧但后来恐惧增加的组、轻度恐惧减少的组、轻度恐惧恶化的组、轻度恐惧稳定组和中度恐惧稳定组。Logistic 回归显示，对不确定性的不容忍、分娩自我效能感和生育偏好是影响这些轨迹的主要因素 （p < 0.05）。结论本研究强调了孕晚期初产妇对分娩恐惧的不同轨迹。不同类别的恐惧出现，每一种都遵循不同的变化路径。 医疗保健提供者可以使用这些信息来制定个性化的干预措施，解决各个阶段的具体问题和影响因素，以支持初产妇在围产期的心理健康。对专业和/或患者护理的影响医疗保健提供者应警惕初产妇对分娩恐惧的认识和反应。这项研究表明，对分娩的恐惧通常在妊娠 32 至 33 周之间开始增加或减少。因此，应在此期间开始筛查和干预，并建立随访机制。提供者还应评估初产妇应对分娩恐惧的能力，提供有针对性的指导和教育，以减少不确定性，提高分娩自我效能感，并最终减轻恐惧。患者或公众捐款没有患者或公众捐款。影响陈述这项研究引起了医疗保健提供者的极大兴趣，建议医疗保健提供者应该对初产妇对分娩恐惧的认识和反应保持警惕。这项研究表明，对分娩的恐惧通常在妊娠 32 至 33 周之间开始增加或减少。因此，应在此期间开始筛查和干预，并建立随访机制。提供者还应评估初产妇应对分娩恐惧的能力，提供有针对性的指导和教育，以减少不确定性，提高分娩自我效能感，并最终减轻恐惧。