Katri Nieminen1,2, Klaas Wijma1, Sanna Johansson1, Emelie K Kinberger1, Elsa-Lena Ryding3, Gerhard Andersson4,5, Lars Bernfort6, Barbro Wijma7. 1. Unit of Medical Psychology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 2. Department of Obstetrics and Gynecology, Vrinnevisjukhuset, Region Council of Östergötland, Norrköping, Sweden. 3. Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 4. Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden. 5. Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 6. Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 7. Unit of Gender and Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Abstract
INTRODUCTION: The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC. MATERIAL AND METHODS: In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis. Medical records were assessed and medical parameters were mapped. Mean costs for healthcare consumption and sick leave during pregnancy were calculated and compared. RESULTS: When means were compared between the groups, the group with severe FOC had more visits for psychosocial reasons (p = 0.001) and more hours on sick leave (p = 0.03) during pregnancy, and stayed longer at the maternity ward (p = 0.04). They also more seldom had normal spontaneous deliveries (p = 0.03), and more often had an elective cesarean section on maternal request (p = 0.02). Postpartum, they more often than the group with low FOC paid visits to the maternity clinic because of complications (p = 0.001) and to the antenatal unit because of adverse childbirth experiences (p = 0.001). The costs for handling women with severe FOC was 38% higher than those for women with low FOC. CONCLUSION: Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.
INTRODUCTION: The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC. MATERIAL AND METHODS: In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis. Medical records were assessed and medical parameters were mapped. Mean costs for healthcare consumption and sick leave during pregnancy were calculated and compared. RESULTS: When means were compared between the groups, the group with severe FOC had more visits for psychosocial reasons (p = 0.001) and more hours on sick leave (p = 0.03) during pregnancy, and stayed longer at the maternity ward (p = 0.04). They also more seldom had normal spontaneous deliveries (p = 0.03), and more often had an elective cesarean section on maternal request (p = 0.02). Postpartum, they more often than the group with low FOC paid visits to the maternity clinic because of complications (p = 0.001) and to the antenatal unit because of adverse childbirth experiences (p = 0.001). The costs for handling women with severe FOC was 38% higher than those for women with low FOC. CONCLUSION:Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.
Authors: Helena Wigert; Christina Nilsson; Anna Dencker; Cecily Begley; Elisabeth Jangsten; Carina Sparud-Lundin; Margareta Mollberg; Harshida Patel Journal: Int J Qual Stud Health Well-being Date: 2020-12
Authors: Sabine L M Logtenberg; Corine J Verhoeven; Katrien Oude Rengerink; Anne-Marie Sluijs; Liv M Freeman; François G Schellevis; Ben Willem Mol Journal: BMC Pregnancy Childbirth Date: 2018-08-25 Impact factor: 3.007