Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis

Introduction Tocophobia is defined as a severe fear of pregnancy and childbirth. There is increasing evidence that tocophobia may have short‐term and long‐term adverse effects on mother and baby. We performed a systematic review and meta‐analysis to determine the global prevalence of tocophobia in pregnancy. Material and methods Relevant articles were identified through searching six relevant databases: MEDLINE, CINAHL, Pubmed, PsycINFO, Maternity & Infant Care and Scopus between 1946 and April 2016. We used search terms for tocophobia prevalence in pregnant women that we agreed on with a medical librarian. There were no language restrictions. Two review authors independently assessed data for inclusion, extracted data and assessed quality using a standardized appraisal tool. Meta‐analysis was performed to determine the overall pooled‐prevalence of tocophobia. Several subgroup and sensitivity analyses were conducted. Results Thirty‐three studies were included in the systematic review from 18 countries of which data from 29 studies were used in the meta‐analysis of 853 988 pregnant women. Definition of tocophobia varied, whereas prevalence rates ranged between 3.7 and 43%. The overall pooled prevalence of tocophobia, using a random‐effects model, was 14% (95% CI 0.12–0.16). Significant heterogeneity was observed (I2 = 99.25%, p = 0.00), which was not explained in subgroup analyses including tocophobia definition used, screening trimester and parity. Conclusion The prevalence of tocophobia is estimated at 14% and appears to have increased in recent years (2000 onwards). Considerable heterogeneity (99.25%) was noted that may be attributed to lack of consensus on the definition of tocophobia, so our results should be interpreted with caution.