Anxiety at the Onset of Active Phase of Labor and some of its Predictors in Iranian Women

Abstract Background and Aim: Severe anxiety during labor can result in adverse maternal and neonatal outcomes. Due to limited studies in Iran and other countries, this study aimed to assess the prevalence of women’s anxiety at the onset of active phase of labor and some of its predictors. Materials and Methods: In this cross-sectional study, the participants included ۷۰۰ low-risk singleton pregnant women with gestational age of ۳۷۰-۴۱۶, hospitalized for vaginal delivery at two teaching hospitals in Tabriz, Iran. The anxiety state [by using the Spielberger’s State Anxiety Inventory (SAI)] and dehydration were assessed at cervical dilatation of ۴-۶ cm. Variables correlated with the anxiety score with P<۰.۲ in the unadjusted analysis were included in the multiple linear regression model to determine the predictors.   Results: The mean of the anxiety score was ۴۹.۳ (SD ۱۱.۷) out of the attainable score of ۲۰-۸۰. About two-thirds of the women had severe (۳۹.۶%) or moderate (۲۶.۶%) anxiety. The predictors of high anxiety score were: high fear (β=۰.۶۱۰), labor induction (β=۰.۱۹۶), dehydration ≥ ۳ h (β=۰.۱۰۹) and < ۳ h (β=۰.۰۷۳), second-hand smoke during pregnancy (β=۰.۰۸۷), and no attendance at childbirth preparation classes (β=۰.۰۵۴). The proportion of variance by all these factors was ۶۲%. Conclusion: Anxiety was very common intrapartum. The during-labor factors including high fear, labor induction, and dehydration were important predictors of the women’s anxiety. It seems that providing the women with appropriate counselling services during pregnancy and responding to their needs during labor could play a significant role in decreasing their anxiety.