Obstetric and perinatal outcomes among women with blood- and injection phobia during pregnancy.

Background: Little is known about how anxiety disorders affect pregnancy outcomes. Therefore we investigated the impact of one anxiety disorder, blood- and injection phobia, on obstetric and neonatal outcomes.

Methods: From a population-based prospectively collected cohort we compared an index group of 110 women with blood- and injection phobia with a control group of 220 women. Standardized medical records were used to collect data. Obstetric and neonatal outcomes e.g. elective cesarean, prematurity, and small for gestational age were used as the main outcome measures.

Results: Women with blood- and injection phobia stated more often a fear of childbirth (p<0.001) and were more frequently delivered by elective cesarean section (p=0.032). The incidence of premature delivery (p=0.028), neonatal morbidity (p=0.001) and the risk of having a baby born small for gestational age (p=0.009) was higher among women with blood- and injection phobia.

Limitations: The medical records, from which all information is drawn, despite standardization, sometimes may lack some information. However, this dilemma exists in both groups.

Conclusions: Women with an anxiety disorder such as blood- and injection phobia are at increased risk for adverse obstetric outcomes, premature delivery and for having a baby born with higher neonatal morbidity. It therefore seems important to identify and treat women with anxiety disorders without delay early during pregnancy in an effort to minimize risks of complications for the woman herself and the child.