Evidence map›Paper›PMID 39844332›Full record

ArticleReproductive health2025

Fear of childbirth and psychiatric disorders decrease the likelihood of subsequent births: a retrospective register-based cohort study.

Elina Silvan, Terhi Saisto, Tia Mäkelä, Katariina Salmela-Aro, Mika Gissler, Laura Lampio

Abstract read
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Article in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Elina SilvanKanta-Häme Central Hospital, Hämeenlinna, Finland. elina.silvan@helsinki.fi.
Terhi SaistoHelsinki University Hospital and University of Helsinki, Helsinki, Finland.
Tia MäkeläHelsinki University Hospital and University of Helsinki, Helsinki, Finland.
Katariina Salmela-AroFaculty of Educational Sciences, University of Helsinki, Helsinki, Finland.
Mika GisslerResearch Center for Child Psychiatry and the Invest Research Flagship, University of Turku, Turku, Finland.
Laura LampioHelsinki University Hospital and University of Helsinki, Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMirroring other developed countries globally, the birth rate has decreased in Finland in recent years. The effects of a fear of childbirth (FOC) and psychiatric disorders on the likelihood of having more than one child remain relatively unstudied. This study aims to assess the influence of FOC, psychiatric disorders, and the mode of first delivery on the likelihood of the second birth among primiparous women.

methodsData were collected from the Medical Birth Register, the Hospital Discharge Register, and Statistics Finland census data. We used the t-test to compare continuous variables and the chi-square test or test for relative proportions to compare categorical variables. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox regression analysis.

resultsAltogether, 317 219 women delivering their first child in 2006-2016 met the inclusion criteria, 216 521 of whom (68.3%) had their second birth during that time. A total of 11 108 (3.5%) of women were diagnosed with FOC during their first pregnancy, 34 381 (10.8%) women were diagnosed with a psychiatric disorder before or during their first pregnancy and 10 331 (3.3%) women received a new diagnosis of a psychiatric condition following the first birth. Between 2006-2021, the second child was born to 47.5% of women with FOC (n = 5276), 56.8% of women with a psychiatric disorder before or during their first pregnancy (n = 19 540), 53.4% of women receiving a psychiatric diagnosis after their first delivery (n = 5514) and 70.2% of women without either of these diagnoses (n = 191 572). Women with FOC had a 22% lower likelihood of the second birth [aHR 0.78 (95% CI 0.76-0.80)] compared to women without FOC. A psychiatric disorder before or during the first pregnancy decreased the likelihood of the second birth by 28% [aHR 0.72 (95% CI 0.71-0.73)] and by 51% (aHR 0.49 (95% CI 0.48-0.50)] with a psychiatric disorder following a first birth compared with women without a diagnosed psychiatric disorder. Among all women, a caesarean section as the mode of a first delivery reduced the likelihood of the second birth.

conclusionFOC and psychiatric disorders are associated with a low birthrate following the first delivery. Caesarean section as the mode of delivery decreases the likelihood of the second birth among women with FOC and psychiatric disorders.

Indexed as

Delivery, ObstetricFearMental DisordersParturitionPregnancy ComplicationsAdultFemaleFinlandHumansParityPregnancyRegistriesRetrospective StudiesYoung AdultBirth rateFear of childbirthMode of deliveryPsychiatric disorders

Identifiers

PMID39844332
PMCPMC11753102

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.