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

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.

In this cross-sectional study, the participants included 700 low-risk singleton pregnant women with gestational age of 370-416, 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 4-6 cm. Variables correlated with the anxiety score with P<0.2 in the unadjusted analysis were included in the multiple linear regression model to determine the predictors.  

The mean of the anxiety score was 49.3 (SD 11.7) out of the attainable score of 20-80. About two-thirds of the women had severe (39.6%) or moderate (26.6%) anxiety. The predictors of high anxiety score were: high fear (β=0.610), labor induction (β=0.196), dehydration ≥ 3 h (β=0.109) and < 3 h (β=0.073), second-hand smoke during pregnancy (β=0.087), and no attendance at childbirth preparation classes (β=0.054). The proportion of variance by all these factors was 62%.

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.