Document Type : Original Article


1 Department of Public Health, Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran, Department of Midwifery, Shahid Rahimi (Tamin Ejtemaei) Hospital, Birjand, Iran

2 Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran

3 Department of Midwifery, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran

4 Department of Public Health, Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran


BACKGROUND: Pregnancy anxiety is associated with a diverse birth outcomes. Mothers’ education
could have a critical role in increasing their self‑efficacy to defeat their anxiety and improve pregnancy
and child birth outcomes. The study was conducted to examine the effect of intervention based on
self‑efficacy theory on pregnancy anxiety and child birth outcomes.
MATERIALS AND METHODS: The study was conducted as a quasi‑experimental design on
60primiparous women (26–28 weeks) in Birjand (East Iranian province) from May to September 2017,
who were randomly divided into intervention and control groups. The intervention group received
8 sessions of 90‑min educational intervention based on self‑efficacy theory strategies besides the
routine prenatal care. Vanden Bergh’s pregnancy anxiety questionnaire and checklist of pregnancy
and delivery outcomes were used for data collection.
RESULTS: The level of pregnancy anxiety was similar in both groups before the intervention, but
immediately and 1 month after the intervention, the mean score of pregnancy anxiety significantly
reduced in the intervention group and significantly increased in the control group (P < 0.001). There
was a significant difference in mean neonatal weight (P < 0.001) between the two groups. Emergency
and elective cesarean section were significantly lower in the intervention group compared to the
control group (P < 0.001), but there were no significant differences in the frequency of preterm
delivery between two groups (P < 0.05).
CONCLUSION: The results provide support for the effectiveness of intervention based on self‑efficacy
theory in reducing pregnancy anxiety and enhancing positive pregnancy outcomes. Hence,
theory‑based educational interventions may serve as a cost‑effective and noninvasive approach to
reduce pregnancy anxiety in Iran.


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