Pregnancy outcomes in women with severe needle phobia

Needle phobia in pregnancy poses a problem as women may refuse medical care because of their fear. The present study investigates the impact of needle phobia on the antenatal and intrapartum care of needle phobic women and reports on the pregnancy and neonatal outcomes.

A retrospective cohort of 112 cases, divided into severe and mild cases of needle phobia, was collected from the anaesthetic referral database. The data were collected manually as well as by using the computerised hospital database, and were analysed using SPSS version 19. Chi-square analysis and unpaired t-test were used to analyse categorical and continuous variables, respectively. The overall departmental statistics for 2009 and 2010 were used as a comparator.

Women with severe needle phobia, compared to those with mild needle phobia, registered late with the antenatal services (17 weeks vs 14 weeks, p<0.05), had a significant delay in obtaining their first antenatal blood tests (25 weeks vs 15 weeks, p<0.0001), consented less often to the booking blood tests (62.8% vs 98.6%, p<0.0001) and antenatal tests (30.2% vs 76.8%, p<0.0001), had low use of pethidine (4.7% vs 24.6%, p<0.01) and a higher demand for general anaesthesia (11.6% vs 0%, p<0.01) and had an increased number of physiological deliveries of the placenta (37.2% vs 8.7%, p<0.0001). The incidence of maternal and neonatal adverse outcomes in both groups was low.

Despite the differences in choice of analgesia and acceptance of routine blood tests, pregnancy outcomes in women with severe needle phobia were good. The study highlighted the importance of adequate risk assessment of all women disclosing their needle phobic status, and of provision of high-standard multidisciplinary care involving primary and secondary healthcare professionals.