Latent profiles and predictors of fear of childbirth in late pregnancy: a parity-specific analysis

Abstract

Fear of childbirth (FoC) is a common psychological concern among women in late pregnancy. Variation in reported prevalence and associated factors across studies reflects methodological heterogeneity and highlights the need for person-centred approaches to identify clinically meaningful subgroups. Data from 745 primiparous and 543 multiparous women were analysed. Latent profile analysis identified distinct FoC profiles separately for each parity group. Guided by the Transactional Model of Stress and Coping, demographic, obstetric, and psychosocial variables — including childbirth cognitions, social support, and coping style — were examined simultaneously using the R3STEP procedure to identify independent predictors of profile membership. Two profiles — a relative low-FoC profile and a relative high-FoC profile —were identified in both parity groups, with the high-FoC profile characterised by consistently higher scores across all 14 fear dimensions. The relative high-FoC profile comprised 41.9% of primiparous women and 37.2% of multiparous women. Greater childbirth pain anticipation and more frequent negative coping consistently predicted membership in the high-FoC profile across both groups. Among primiparous women, lower social support, lower income satisfaction, and internet-based knowledge acquisition were additionally associated with profile membership. Among multiparous women, unplanned pregnancy, lower income satisfaction, lower coping efficacy beliefs, attendance at hospital-based prenatal education as a protective factor, and internet use as a risk factor were additionally associated with profile membership. Clinically significant FoC is common among both primiparous and multiparous women in late pregnancy. Childbirth pain anticipation and negative coping represent shared, modifiable targets for intervention, whereas parity-specific determinants support tailored approaches to FoC screening, prenatal education, and psychological support.