SynthesisArchives of women's mental health2026
Global prevalence and associated factors of severe fear of childbirth: a systematic review and Meta-Analysis.
Synthesis in Archives of women's mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed.
- The mediating role of fetal health anxiety in the relationship between fear of childbirth and preferred mode of delivery among pregnant women.BMC pregnancy and childbirth · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFear of childbirth (FoC), particularly its severe form (tokophobia), is a significant public health concern associated with adverse maternal and neonatal outcomes. While previous meta-analyses have provided global prevalence estimates, significant knowledge gaps remain due to limited studies. This study aimed to provide an updated global prevalence estimate of severe FoC and explore sources of heterogeneity and associated risk factors.
methodsA systematic review and meta-analysis was conducted following PRISMA and MOOSE guidelines. We searched international and Persian databases from inception until June 2025 for cross-sectional and cohort studies reporting severe FoC prevalence in pregnant women using validated tools with defined cutoffs. Two reviewers independently performed data extraction and quality assessment using the Newcastle-Ottawa Scale. Random-effects models were used for meta-analysis, with heterogeneity assessed via I² statistic. Subgroup analyses and meta-regressions explored variation sources. Risk factors were synthesized descriptively, though nulliparity and unplanned pregnancy allowed meta-analysis.
resultsFrom 67 included studies (n = 905,504 participants), the pooled prevalence of severe FoC was 16.5% (95% CI: 13.8-19.5%), with significant heterogeneity (I² = 99.45%). Assessment tools and cutoffs were major heterogeneity sources (p < 0.001), with prevalence ranging from 3.7% to 58.7%. Country of study was also a significant moderator (p < 0.001). Meta-regression showed no significant association with maternal age, gestational age, nulliparity percentage, or publication year. Key risk factors included previous traumatic birth, anxiety/depression symptoms, and inadequate social support. Nulliparous women had higher odds of severe FoC (OR = 1.36, 95% CI: 1.04-1.76), as did those with unplanned pregnancy (OR = 1.85, 95% CI: 1.29-2.65).
conclusionSevere FoC affects approximately one in six women globally. The substantial heterogeneity, largely due to methodological variations, underscores the need for standardized assessment protocols. Identified associations with factors such as previous traumatic birth and anxiety highlight the condition's multifactorial nature, emphasizing the importance of targeted screening and evidence-based interventions aligned with Sustainable Development Goal (SDG) 3 to improve maternal mental health.
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