Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland

Abstract Introduction Fear of childbirth (FOC) is a common obstetrical challenge that complicates about every 10th pregnancy. Background factors of FOC are diverse. We evaluated the association of induced abortion (IA) and FOC in subsequent pregnancy. Material and methods Population‐based register s...

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Main Authors: Venla Kemppainen, Maarit Mentula, Tomi Seppälä, Mika Gissler, Hanna Rouhe, Saisto Terhi, Oskari Heikinheimo, Maarit Niinimäki
Format: Article
Language:English
Published: Wiley 2024-02-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14718
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author Venla Kemppainen
Maarit Mentula
Tomi Seppälä
Mika Gissler
Hanna Rouhe
Saisto Terhi
Oskari Heikinheimo
Maarit Niinimäki
author_facet Venla Kemppainen
Maarit Mentula
Tomi Seppälä
Mika Gissler
Hanna Rouhe
Saisto Terhi
Oskari Heikinheimo
Maarit Niinimäki
author_sort Venla Kemppainen
collection DOAJ
description Abstract Introduction Fear of childbirth (FOC) is a common obstetrical challenge that complicates about every 10th pregnancy. Background factors of FOC are diverse. We evaluated the association of induced abortion (IA) and FOC in subsequent pregnancy. Material and methods Population‐based register study based on three Finnish national registers: the Register of Induced Abortions, the Medical Birth Register and the Hospital Discharge Register. The study cases were primigravid women undergoing an IA in 2000–2015 and subsequent pregnancy ending in live singleton birth up to 2017. Each case had three controls, matched by age and residential area, whose first pregnancy ended in a live birth. The main outcome was the incidence of FOC in the subsequent pregnancy. In a secondary analysis, we assessed other risk factors for FOC. Results The study cohort consisted of 21 455 women and 63 425 controls. Altogether, 4.2% of women had a diagnosis of FOC. The incidence was higher in women with a history of IA than in controls (5.6% vs 3.7%, P < 0.001). A history of IA was associated with higher odds for FOC: adjusted odds ratio [aOR] 1.20 with 95% confidence interval (CI) 1.11–1.30. In addition, a history of psychiatric diagnosis (aOR 3.48, 95% CI 3.15–3.83), high maternal age, 30–39 years old (aOR 1.55, 95% CI 1.43–1.67; P < 0.001) and ≥40 years old (aOR 3.00, 95% CI 2.37–3.77; P < 0.001) and smoking (aOR 1.20, 95% CI 1.11–1.31; P < 0.001) were associated with increased odds for FOC. Women living in densely populated or rural areas and those with lower socioeconomic class had lower odds for FOC. Conclusions A history of IA is associated with increased odds for FOC in subsequent pregnancy. However, the associations of FOC with a history of psychiatric diagnosis and elevated maternal age (especially ≥40 years old) are more pronounced.
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spelling doaj-art-e0f109522ac4416e881d37d538bfc46a2025-08-20T03:31:00ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-02-01103224124910.1111/aogs.14718Fear of childbirth after induced abortion in primiparous women: Population‐based register study from FinlandVenla Kemppainen0Maarit Mentula1Tomi Seppälä2Mika Gissler3Hanna Rouhe4Saisto Terhi5Oskari Heikinheimo6Maarit Niinimäki7Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandAalto University Aalto FinlandFinnish Institute of Health and Welfare (THL) Invest Research Flagship and University of Turku Turku FinlandDepartment of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandDepartment of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center University of Oulu and Oulu University Hospital Oulu FinlandAbstract Introduction Fear of childbirth (FOC) is a common obstetrical challenge that complicates about every 10th pregnancy. Background factors of FOC are diverse. We evaluated the association of induced abortion (IA) and FOC in subsequent pregnancy. Material and methods Population‐based register study based on three Finnish national registers: the Register of Induced Abortions, the Medical Birth Register and the Hospital Discharge Register. The study cases were primigravid women undergoing an IA in 2000–2015 and subsequent pregnancy ending in live singleton birth up to 2017. Each case had three controls, matched by age and residential area, whose first pregnancy ended in a live birth. The main outcome was the incidence of FOC in the subsequent pregnancy. In a secondary analysis, we assessed other risk factors for FOC. Results The study cohort consisted of 21 455 women and 63 425 controls. Altogether, 4.2% of women had a diagnosis of FOC. The incidence was higher in women with a history of IA than in controls (5.6% vs 3.7%, P < 0.001). A history of IA was associated with higher odds for FOC: adjusted odds ratio [aOR] 1.20 with 95% confidence interval (CI) 1.11–1.30. In addition, a history of psychiatric diagnosis (aOR 3.48, 95% CI 3.15–3.83), high maternal age, 30–39 years old (aOR 1.55, 95% CI 1.43–1.67; P < 0.001) and ≥40 years old (aOR 3.00, 95% CI 2.37–3.77; P < 0.001) and smoking (aOR 1.20, 95% CI 1.11–1.31; P < 0.001) were associated with increased odds for FOC. Women living in densely populated or rural areas and those with lower socioeconomic class had lower odds for FOC. Conclusions A history of IA is associated with increased odds for FOC in subsequent pregnancy. However, the associations of FOC with a history of psychiatric diagnosis and elevated maternal age (especially ≥40 years old) are more pronounced.https://doi.org/10.1111/aogs.14718fear of childbirth, childbirthinduced abortion
spellingShingle Venla Kemppainen
Maarit Mentula
Tomi Seppälä
Mika Gissler
Hanna Rouhe
Saisto Terhi
Oskari Heikinheimo
Maarit Niinimäki
Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
Acta Obstetricia et Gynecologica Scandinavica
fear of childbirth, childbirth
induced abortion
title Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
title_full Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
title_fullStr Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
title_full_unstemmed Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
title_short Fear of childbirth after induced abortion in primiparous women: Population‐based register study from Finland
title_sort fear of childbirth after induced abortion in primiparous women population based register study from finland
topic fear of childbirth, childbirth
induced abortion
url https://doi.org/10.1111/aogs.14718
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