The characteristics and prevalence of phobias in pregnancy

Selina Nath; Paula Busuulwa; Elizabeth G Ryan; Fiona L Challacombe; Louise M Howard

doi:10.1016/j.midw.2019.102590

The characteristics and prevalence of phobias in pregnancy

Midwifery. 2020 Mar:82:102590. doi: 10.1016/j.midw.2019.102590. Epub 2019 Nov 28.

Authors

Selina Nath¹, Paula Busuulwa², Elizabeth G Ryan³, Fiona L Challacombe⁴, Louise M Howard⁴

Affiliations

¹ Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Electronic address: selina.nath@kcl.ac.uk.
² GKT School of Medical Education, King's College London, UK Guy's campus, London SE1 1UL, UK.
³ Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
⁴ Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.

PMID: 31864080
DOI: 10.1016/j.midw.2019.102590

Abstract

Objective: The primary objective was to estimate the population prevalence of specific phobias (including pregnancy related specific phobias) and associated mental disorders. The secondary objective was to investigate the effectiveness of routinely collected screening tools (depression and anxiety screens, Whooley and GAD-2 respectively) in identifying specific phobias. Specific phobias are the most common anxiety disorder to occur during pregnancy, but studies on prevalence and clinical correlates of specific phobias, including pregnancy related specific phobias are lacking.

Design: Cross-sectional survey using a two-phase sampling design stratified according to being positive or negative on the Whooley questions routinely asked by midwives. Approaching all whooley positive women and drawing a random sample of Whooley negative women. Sampling weights were used to account for the bias induced by the stratified sampling.

Participants: 545 pregnant women attending their first antenatal appointment. Language interpreters were used where required.

Setting: Inner-city maternity service, London, UK.

Measurements: The Structured Clinical Interview for DSM-IV Axis I Mental Disorders were administered to assess mental disorders and 544 women responded to the anxiety module on specific phobias.

Results: The maternity population prevalence estimate for specific phobias was 8.4% (95%CI: 5.8-12.1%) and for pregnancy related phobias was 1.5% (95%CI: 0.6-3.7%), most of which were needle phobias. The prevalence estimate of tokophobia was 0.032% (95%CI: 0.0044-0.23%). Over half (52.4%) the women with specific phobias had comorbid mental disorders. Routinely administered screening tools (Whooley and GAD-2) were not helpful in identifying phobias.

Key conclusions and implications for practice: Phobias in pregnancy are common but pregnancy related phobias are rare, particularly tokophobia. As routinely administered screening tools were not helpful in identifying phobias, other indicators could be considered, such as avoidance of blood tests and requests for caesarean sections.

Keywords: Antenatal; Anxiety; Pregnancy; Prevalence; Specific phobia.

MeSH terms

Adolescent
Adult
Child
Cross-Sectional Studies
Female
Humans
London / epidemiology
Mass Screening / methods
Mass Screening / statistics & numerical data
Middle Aged
Phobic Disorders / epidemiology
Phobic Disorders / psychology*
Pregnancy
Pregnant Women / psychology*
Prevalence*
Psychiatric Status Rating Scales
Psychometrics / instrumentation
Psychometrics / methods
Surveys and Questionnaires

Abstract

MeSH terms

Grants and funding