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Background <p>Tokophobia, defined as an intense fear of childbirth, is a significant psychological concern affecting many pregnant women worldwide. The objective of this study was to investigate the associations between psychosocial and socio-demographic factors and tokophobia among pregnant women in Western Iran.</p> Methods <p>This descriptive-analytical study was conducted in 2024 among 1001 pregnant women in Kermanshah, Iran. Participants were selected through multi-stage sampling from urban health centers, affiliated outpatient clinics, and private obstetric offices. Data were collected via a self-administered questionnaire including demographic items and the Tokophobia Assessment Questionnaire (TAQ). After screening, 992 responses were analyzed. Multiple linear regression analysis was applied to examine correlations between tokophobia scores and selected demographic and psychosocial variables in both unadjusted and adjusted models.</p> Results <p>In the adjusted multivariate models, several protective and risk factors for tokophobia emerged. Higher husband’s age was consistently protective (26–35&#xa0;years: β = − 4.12, p = 0.005; 36–45&#xa0;years: β = − 7.90, p &lt; 0.001; ≥ 46&#xa0;years: β = − 7.36, p = 0.002), as were later gestational weeks (11–29: β = − 2.61, p = 0.041; ≥ 30: β = − 4.36, p = 0.003). Protective associations were also observed for husbands’ private employment (β = − 4.51, p &lt; 0.001), better economic status (β = − 4.39 to − 3.66, p ≤ 0.035), health insurance (β = − 2.58, p = 0.025), and natural delivery (β = − 2.98, p = 0.002). Conversely, maternal secondary education (β = 5.74, p = 0.001), husband’s academic education (β = 4.76, p = 0.037), lack of spousal support (β = 3.86, p &lt; 0.001), and parental inadequacy (β = 3.52, p &lt; 0.001) were positively associated with tokophobia.</p> Conclusions <p>These findings highlight the correlational role of psychosocial stressors and selected socio-demographic variables in relation to childbirth-related fear. Given the cross-sectional design, the associations observed should be interpreted as correlational only, without implying causality or temporal direction. The results suggest that psychosocial concerns, such as lack of spousal support and parental inadequacy, may be more strongly related to tokophobia than demographic characteristics, underscoring the need for longitudinal studies to clarify causal pathways.</p>

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Psychosocial and demographic factors associated with tokophobia in pregnant women: evidence from Western Iran

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Mehdi Mirzaei-Alavijeh,
  • Mehdi Moradinazar,
  • Negar Karimi,
  • Samane Dasta,
  • Farzad Jalilian

摘要

Background

Tokophobia, defined as an intense fear of childbirth, is a significant psychological concern affecting many pregnant women worldwide. The objective of this study was to investigate the associations between psychosocial and socio-demographic factors and tokophobia among pregnant women in Western Iran.

Methods

This descriptive-analytical study was conducted in 2024 among 1001 pregnant women in Kermanshah, Iran. Participants were selected through multi-stage sampling from urban health centers, affiliated outpatient clinics, and private obstetric offices. Data were collected via a self-administered questionnaire including demographic items and the Tokophobia Assessment Questionnaire (TAQ). After screening, 992 responses were analyzed. Multiple linear regression analysis was applied to examine correlations between tokophobia scores and selected demographic and psychosocial variables in both unadjusted and adjusted models.

Results

In the adjusted multivariate models, several protective and risk factors for tokophobia emerged. Higher husband’s age was consistently protective (26–35 years: β = − 4.12, p = 0.005; 36–45 years: β = − 7.90, p < 0.001; ≥ 46 years: β = − 7.36, p = 0.002), as were later gestational weeks (11–29: β = − 2.61, p = 0.041; ≥ 30: β = − 4.36, p = 0.003). Protective associations were also observed for husbands’ private employment (β = − 4.51, p < 0.001), better economic status (β = − 4.39 to − 3.66, p ≤ 0.035), health insurance (β = − 2.58, p = 0.025), and natural delivery (β = − 2.98, p = 0.002). Conversely, maternal secondary education (β = 5.74, p = 0.001), husband’s academic education (β = 4.76, p = 0.037), lack of spousal support (β = 3.86, p < 0.001), and parental inadequacy (β = 3.52, p < 0.001) were positively associated with tokophobia.

Conclusions

These findings highlight the correlational role of psychosocial stressors and selected socio-demographic variables in relation to childbirth-related fear. Given the cross-sectional design, the associations observed should be interpreted as correlational only, without implying causality or temporal direction. The results suggest that psychosocial concerns, such as lack of spousal support and parental inadequacy, may be more strongly related to tokophobia than demographic characteristics, underscoring the need for longitudinal studies to clarify causal pathways.