Influencing Factors of Prenatal Fear of Childbirth among Elderly Pregnant Women and Construction of a Prediction Model

YANG Min; ZHAO Haiyan; SHANG Xinyu; HAO Jinxiu; SU Ling

doi:10.3639/i.issn.2095-3097.2025.01.021

Abstract：Objective To investigate the status and influencing factors of prenatal fear of childbirth among elderly pregnant women,and to construct a prediction model.Methods A total of 120 elderly pregnant women who received prenatal check-ups in the Zhangjiakou First Hospital from January to December 2021 were selected.The Childbirth Attitudes Questionnaire(CAQ)was used to evaluate their prenatal fear of childbirth.Based on evaluation results,the subjects were divided into the fear of childbirth group and non-fear of childbirth group.Univariate and multivariate Logistic regression analysis were conducted to screen the factors influencing prenatal fear of childbirth among elderly pregnant women,and a prediction model was constructed based on analysis results.The receiver operating characteristic(ROC)curve was employed to evaluate the predictive efficacy of the model for prenatal fear of childbirth among elderly pregnant women.Results In this study,93(77.50%)women had fear of childbirth,and 27(22.50%)did not have.The proportions of women with education level of middle school or below,history of childbirth trauma,artificial insemination,without the use of pregnancy-associated APPs,and the Self-Rating Anxiety Scale(SAS)scores in the fear of childbirth group were significantly higher than those of the non-fear of childbirth group(P<0.05).In addition,the 10-item Connor-Davidson Resilience Scale(CD-RISC-10)scores,the Social Support Rating Scale(SSRS)scores,and the Childbirth Self-Efficacy Inventory(CBSEI-C32)scores were significantly lower in the fear of childbirth group than those of the non-fear of childbirth group(P<0.05).Pearson correlation analysis found that the scores for dimensions of CAQ and total CAQ score were positively correlated with SAS score,and negatively correlated with CD-RISC-10 score,SSRS score and CBSEI-C32 score(P<0.05).Multivariate logistic regression analysis found that education level,history of childbirth trauma,artificial insemination,SAS score,CD-RISC-10 score,SSRS score,and CBSEI-C32 score were independent influencing factors for prenatal fear of childbirth among elderly pregnant women(P<0.05).The area under the curve(AUC)of the constructed prediction model for predicting prenatal fear of childbirth in elderly pregnant women was 0.924,with a sensitivity of 81.72%and a specificity of 88.89%.Conclusion Elderly pregnant women have a higher incidence of fear of childbirth,which is influenced by factors such as education level,history of childbirth trauma,artificial insemination,SAS score,CD-RISC-10 score,SSRS score,and CBSEI-C32 score.The prediction model constructed based on these factors has high predictive value for fear of childbirth among elderly pregnant women.