Goodness of fit indices for the model.

BackgroundGiven maternal health is a major health indicator, the present research aimed at determining the causal relationships of spiritual health, worries, stress and perceived social support with the fear and experience of childbirth in pregnant women.MethodsThe present longitudinal prospective research recruited 352 pregnant women presenting to selected health centers in Qazvin, Iran in 2021. The data were collected using the Childbirth Experience Questionnaire-2 (CEQ-2), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Persian version of the Pregnancy Worries and Stress Questionnaire (PWSQ), the Spiritual Health Questionnaire, the Socioeconomic Status (SES) questionnaire and a sociodemographic checklist, and were analyzed in SPSS-25 and Lisrel-8.8.ResultsThe mean age of the participants was 28.1±6.8 years. According to the results of the path analysis, among the variables related to fear of childbirth, childbirth experience (B = -0.37, CI:-0.44;-0.22) in the direct path and perceived social support (B = -0.51, CI:-0.58;-0.43) in both direct and indirect paths demonstrated the most significant negative relationship. Among the variables related to childbirth experience, pregnancy worries and stress had a negative causal relationship (B = -0.06, CI:-0.079;-0.043) in the direct path, spiritual health showed the highest significant positive relationship (B = 0.01, CI: 0.008; 0.012) in the indirect path, and perceived social support (B = 0.112, CI: 0.092; 0.131) and the number of children (B = 0.32,CI: 0.30; 0.34) demonstrated the highest significant positive relationship in both direct and indirect paths. In other words, childbirth experience becomes more desirable as spiritual health, social support, and the number of children increases, and it becomes less desirable as pregnancy worries and stress rise.ConclusionAccording to the present findings, various psychological, social, and spiritual factors are associated with childbirth fear and experience. It is thus necessary to utilize appropriate methods and promote training and support to reduce the adverse outcomes of childbirth.背景 鉴于孕产妇健康是一项重要的健康评价指标，本研究旨在明确孕妇的精神健康状态、焦虑情绪、压力水平及感知社会支持与分娩恐惧及分娩体验之间的因果关联。 方法 本纵向前瞻性研究于2021年在伊朗加兹温的选定卫生中心招募了352名孕妇。研究采用分娩体验问卷-2（Childbirth Experience Questionnaire-2，CEQ-2）、威玛分娩预期/体验问卷（Wijma Delivery Expectancy/Experience Questionnaire，W-DEQ）、多维感知社会支持量表（Multidimensional Scale of Perceived Social Support，MSPSS）、波斯语版妊娠担忧与压力问卷（Pregnancy Worries and Stress Questionnaire，PWSQ）、精神健康问卷、社会经济地位（Socioeconomic Status，SES）问卷以及社会人口学问卷收集数据，并通过SPSS-25和Lisrel-8.8进行统计分析。 结果 研究对象的平均年龄为28.1±6.8岁。路径分析结果显示，在与分娩恐惧相关的变量中，分娩体验（标准化回归系数B=-0.37，置信区间（Confidence Interval，CI）：-0.44~-0.22）的直接路径效应，以及感知社会支持（B=-0.51，置信区间（Confidence Interval，CI）：-0.58~-0.43）的直接与间接路径效应，均呈现最为显著的负向关联。在与分娩体验相关的变量中，妊娠担忧与压力在直接路径中呈现负向因果关联（B=-0.06，置信区间（Confidence Interval，CI）：-0.079~-0.043）；精神健康在间接路径中呈现最高程度的显著正向关联（B=0.01，置信区间（Confidence Interval，CI）：0.008~0.012）；而感知社会支持（B=0.112，置信区间（Confidence Interval，CI）：0.092~0.131）与子女数量（B=0.32，置信区间（Confidence Interval，CI）：0.30~0.34）在直接与间接路径中均呈现最高程度的显著正向关联。换言之，随着精神健康水平、社会支持程度及子女数量的提升，分娩体验会更趋良好；而妊娠担忧与压力的升高则会使分娩体验变差。 结论 本研究结果显示，多种心理、社会及精神因素均与分娩恐惧及分娩体验相关。因此，有必要采用适宜的干预手段，推广相关培训与支持服务，以降低分娩不良结局的发生风险。