Mapping the course of fear of childbirth: A structured data-informed approach to identifying key predictors and outcomes.

BACKGROUND: Up to 15% of pregnant women experience fear of childbirth, which can affect both mother and infant. Previous studies were mostly cross-sectional and examined only a limited set of predictors or outcomes. The present study assessed a broad range of predictors and outcomes of individual differences in baseline and rate of change of fear of childbirth in a comprehensive model, capturing fluctuations in fear of childbirth throughout pregnancy. METHODS: Analyses were performed in 2617 women from the Brabant Study. Using a structured data-informed approach, the dataset was split into a training (70%) and test (30%) dataset for model building and validation. Data were collected at 12, 20, and 28 weeks of pregnancy and 8-10 weeks postpartum. Latent growth curve modeling examined individual trajectories of fear of childbirth across three trimesters of pregnancy. RESULTS: Higher prenatal depression scores predicted higher baseline fear of childbirth levels, whereas multiparity and higher non-judging scores predicted lower baseline levels. High education level was associated with a steeper increase of fear of childbirth throughout pregnancy. Furthermore, higher fear of childbirth baseline levels predicted higher postnatal depression scores, lower postnatal mother-infant bonding scores, lower birth weight, and greater likelihood of epidural analgesia during birth. In contrast, higher fear of childbirth growth levels throughout pregnancy predicted lower postnatal depression scores and higher birth weight. CONCLUSION: This study provides a more detailed understanding of fear of childbirth across pregnancy and highlights the importance of early, targeted screening and intervention to support maternal mental health and optimize birth outcomes.