The relationship between quality of life and pregnancy anxiety with the mediation of childbirth self-efficacy and social support

Tavangar Dehghan, Mahboubeh; Sodagar, Sheida; Nayebinia, Anvar Sadat

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دوره 34، شماره 1 - ( 1-1405 )

جلد 34 شماره 1 صفحات 71-58

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The relationship between quality of life and pregnancy anxiety with the mediation of childbirth self-efficacy and social support

Mahboubeh Tavangar Dehghan¹

، Sheida Sodagar^*²

، Anvar Sadat Nayebinia³

1- Dept of Psychology, Ro.C., Islamic Azad University, Roudehen, Iran
2- Dept of Health Psychology, Ka.C, Islamic Azad University, Karaj, Iran ، sh.sodagar@iau.ac.ir
3- Dept of Midwifery, Ka.C, Islamic Azad University, Karaj, Iran

چکیده: (406 مشاهده)

Introduction: Pregnancy is accompanied by physiological and psychological changes that can affect mothers’ quality of life and anxiety levels. Examining mediating factors such as childbirth self-efficacy and social support can help identify effective strategies to improve maternal mental health. Therefore, the present study aimed to investigate the relationship between quality of life and pregnancy anxiety with the mediating role of childbirth self-efficacy and social support and to test the fit of a correlation model among these variables.
Materials & Methods: This descriptive-correlational study was conducted on 200 pregnant women who were referred to Shohada-ye Gomnam Comprehensive Health Center, Shohada-ye Golzar Comprehensive Health Center, and Agh-Tappeh Comprehensive Health Center of Karaj in 2025. Participants were selected through convenience sampling and completed a demographic information form along with standardized questionnaires, including pregnancy anxiety, quality of life, childbirth self-efficacy, and perceived social support. Data were analyzed using Pearson correlation, structural equation modeling, and AMOS-24 software.
Results: The results showed that there was a positive and significant relationship between quality of life, childbirth self-efficacy, and perceived social support. In contrast, pregnancy anxiety had a negative and significant relationship with these three variables. Quality of life directly reduced pregnancy anxiety (β=-0.542, p=0.001). Also, perceived social support (β=-0.226, p=0.010) and childbirth self-efficacy (β=-0.273, p=0.001) were also directly related to reducing pregnancy anxiety. In addition, quality of life also indirectly reduced pregnancy anxiety through increasing perceived social support (β=-0.136, p=0.001) and childbirth self-efficacy (β=-0.100, p=0.001). The proposed model also had a good fit.
Conclusion: Based on these findings, it can be concluded that childbirth self-efficacy and perceived social support serve as effective mediators in the relationship between quality of life and pregnancy anxiety.

واژه‌های کلیدی: pregnancy، anxiety، self-efficacy، social support، quality of life

متن کامل [PDF 654 kb] (220 دریافت)

یادداشت سردبیر: پژوهشي | موضوع مقاله: زنان وزایمان
دریافت: 1404/9/10 | پذیرش: 1404/11/27 | انتشار: 1405/1/5

فهرست منابع

1. Khosravi SM, Azizi M, Abdollahi S, Aghaei H. Prediction of postpartum depression based on marital satisfaction, body satisfaction, and dysfunctional beliefs in pregnant women of Bukan. Arak Univ Med Sci J. 2024;27:3-15. doi: 10.61186/jams.27.2.68.

2. Rondung E, Massoudi P, Nieminen K, Wickberg B, Peira N, Silverstein R, et al. Identification of depression and anxiety during pregnancy: A systematic review and meta-analysis of test accuracy. Acta Obstet Gynecol Scand. 2024;103:423-36. doi: 10.1111/aogs.14734.

3. Cheraghi P, Jamshidi-Manesh M. Relationship between maternal–fetal attachment, anxiety, and demographic factors in primiparous women with high-risk pregnancy. Iran J Nurs. 2021;34:46-59. doi: 10.32598/ijn.34.6.4.

4. Pownall M, Hutter RRC, Rockliffe L, Conner M. Memory and mood changes in pregnancy: a qualitative content analysis of women's first-hand accounts. J Reprod Infant Psychol. 2023;41:516-27. doi: 10.1080/02646838.2022.2052827.

5. Griffiths A, Shannon OM, Brown T, Davison M, Swann C, Jones A, et al. Associations between anxiety, depression, and weight status during and after pregnancy: A systematic review and meta-analysis. Obes Rev. 2024;25:e13668. doi: 10.1111/obr.13668.

6. Eakley R, Lyndon A. Disparities in Screening and Treatment Patterns for Depression and Anxiety During Pregnancy: An Integrative Review. J Midwifery Womens Health. 2024;69:847-62. doi: 10.1111/jmwh.13679.

7. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord. 2016;191:62-77. doi: 10.1016/j.jad.2015.11.014.

8. Schwarze CE, von der Heiden S, Wallwiener S, Pauen S. The role of perinatal maternal symptoms of depression, anxiety and pregnancy-specific anxiety for infant's self-regulation: A prospective longitudinal study. J Affect Disord. 2024;346:144-53. doi: 10.1016/j.jad.2023.10.035.

9. Testouri F, Hamza M, Amor AB, Barhoumi M, Fakhfakh R, Triki A, et al. Anxiety and Depression Symptoms in At-Risk Pregnancy: Influence on Maternal-Fetal Attachment in Tunisia. Matern Child Health J. 2023;27:2008-16. doi: 10.1007/s10995-023-03736-y.

10. Nejad-Hoseinian Z, Bakhtiarpour S, Zangeneh-Motlagh F. Predictive model of quality of life based on maternal–fetal attachment with the mediating role of pregnancy anxiety in pregnant women. J Modern Psychol Res. 2023;18:251-9. doi: 10.22034/JMPR.2023.16517.

11. Vargas-Escobar LM, Reina-Gamba NC, Medellín-Olaya J, Consuegra-Pareja CA. Palliative home care: health-related quality of life. BMJ Support Palliat Care. 2023;13:e282-e286. doi: 10.1136/bmjspcare-2021-003198.

12. Wójcik M, Aniśko B, Siatkowski I. Quality of life in women with normal pregnancy. Sci Rep. 2024;14:12434. doi: 10.1038/s41598-024-63355-7.

13. Martín-Vázquez C, Urchaga-Litago JD, García-Fernández R, Calvo-Ayuso N, Quiroga-Sánchez E, Liébana-Presa C. Quality of life and social support during pregnancy in Spanish population. A longitudinal study. Midwifery. 2024;137:104119. doi: 10.1016/j.midw.2024.104119.

14. Grossian M, Radnia N, Daneshvar F, Talebi-Ghanaat A, Masnadjam R, Alimohammadi N. Effect of education and telephone follow-up by nurse (telenursing) on self-efficacy and quality of life in pregnant women with diabetes during the COVID-19 pandemic: a clinical trial. AJNMC. 2024;32:140-9 doi: 10.32592/ajnmc.32.2.140.

15. Simon T, Fikadu K, Afework B, Alemu H, Kussia B. Childbirth Self-Efficacy and Its Associated Factors among Pregnant Women in Arba Minch Town, Southern Ethiopia, 2023: A Cross-Sectional Study. J Pregnancy. 2024;2024:6478172. doi: 10.1155/2024/6478172.

16. Simon, T., Berhe, A. K., Gebretsadik, G. G., & Dessalegn, M. (2023). Childbirth self-efficacy and associated factors among pregnant women in Arba Minch town, southern Ethiopia: A community-based cross-sectional study. Journal of Pregnancy; 66(7), 27_47.

17. Abdolalipour S, Mohammad-Alizadeh Charandabi S, Mashayekh-Amiri S, Mirghafourvand M. The effectiveness of mindfulness-based interventions on self-efficacy and fear of childbirth in pregnant women: A systematic review and meta-analyses. J Affect Disord. 2023;333:257-70. doi: 10.1016/j.jad.2023.04.020.

18. Shahidi MS, Amidi-Mazaheri M, Hasanzadeh A, Sadat-Shahidi A. Analysis of factors affecting natural childbirth self-efficacy in pregnant women. Health System Res. 2021;17:16-21. doi: 10.22122/jhsr.v17i1.1403.

19. Bilgin NC, Coskun H, Tunc GC, Boyuk M, Deger HS. Predictive Power of Self-Efficacy on the Fear of Childbirth in Pregnant Women: Underlying Mechanisms of Social Support as a Mediator and the COVID-19 Fear as a Moderator. Niger J Clin Pract. 2024;27:330-37. doi: 10.4103/njcp.njcp_471_23.

20. Bedaso A, Adams J, Peng W, Sibbritt D. The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women. BMC Pregnancy Childbirth. 2023;23:372. doi: 10.1186/s12884-023-05708-0.

21. Zhu JS, Wang R, Li Y, Fu YJ, Liu HY, Li JQ, et al. The mediating effect of perceived social support in the relationship between maternal personality traits and pregnancy-related anxiety. Zhonghua Yu Fang Yi Xue Za Zhi. 2023;57:187-92. Chinese. doi: 10.3760/cma.j.cn112150-20220504-00438.

22. Tani F, Castagna V, Ponti L. Mothers' social perceived support, anxiety and prenatal attachment to child: Which direct and indirect influences on delivery clinical indices. Int J Health Sci Res. 2017; 7: 346-52. doi:10.1027/2512-8442/a000103.

23. Zakker N, Dasht-Bozorgi Z. The relationship of social support, quality of life, and vitality with pregnancy anxiety in primiparous women. Soc Health. 2018;5:366-74. doi:10.22037/ch.v5i4.19308.

24. Wang Y, Gu J, Zhang F, Xu X. The mediating role of social support and resilience between self-efficacy and prenatal stress: a mediational analysis. BMC Pregnancy Childbirth. 2023;23:866. doi: 10.1186/s12884-023-06184-2.

25. Nouri N, Naghsh-Tabrizi M. Predicting pregnancy anxiety based on fertility motives, early maladaptive schemas, marital satisfaction, and quality of life. Women’s Psychol Soc Stud. 2024;22:3-18. doi: 10.22051/JWSPS.2024.42087.2691.

26. Abbasi-Fard M, Mirzaei-Khalilabadi S, Aghamohammadhosseini P, Bagheri F, Kamiab Z. Correlation between Social Support, Pregnancy Distress, and Anxiety with Quality of Life of Primiparous Women in Rafsanjan City in 2024. Toloo-e Behdasht. 2025; 24:1-16. doi: ‎ 10.18502/tbj.v24i1.18925.

27. Shakarami A, Mirghafourvand M, Abdolalipour S, Jafarabadi MA, Iravani M. Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women. BMC Pregnancy Childbirth. 2021; 21:642. doi: 10.1186/s12884-021-04114-8.

28. Nagandla K, Nalliah S, Yin LK, Abd Majeed Z, Ismail M, Zubaidah S, et al. (2016). Prevalence and associated risk factors of depression, anxiety and stress in pregnancy. Int J Reproduc, Contracep, Obstetrics Gynecol. 2016; 5: 2380-9. doi:10.18203/2320-1770.ijrcog20162132.

29. Yu M, Qiu T, Liu C, Cui Q, Wu H. The mediating role of perceived social support between anxiety symptoms and life satisfaction in pregnant women: a cross-sectional study. Health Qual Life Outcomes. 2020;18:223. doi: 10.1186/s12955-020-01479-w.

30. Nikbakht-Moghadam F, Sadeghi-Aval Sh, Amini L, Haghani Sh. The relationship of self-efficacy and attitudes toward natural childbirth with pregnancy anxiety in primiparous women in Shahriar health centers 2018. Nurs Midwifery J. 2020;18:210-22.

31. Tabachnick BG, Fidell LS. Using multivariate statistics. 2007; 5th ed. Boston, MA: Pearson Education.

32. Van den Bergh BRH. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. J Prenatal Perinatal Psychol Health.1990; 5: 119-30.

33. Hodai M, Taghiloo S. Prediction of pregnancy anxiety based on personality traits and spouse’s emotional intelligence. New Psychol Ideas. 2020;6:1–14.

34. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403-9. doi: 10.1016/0277-9536(95)00112-k.

35. Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh S. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. SJSPH 2006; 4:1-12.

36. Lowe NK. Maternal confidence for labor: development of the Childbirth Self-Efficacy Inventory. Res Nurs Health. 1993;16:141-9. doi: 10.1002/nur.4770160209.

37. Khorsandi M, Ghofranipour F, Faghihzadeh S, Hidarnia A, Bagheban AA, Aguilar-Vafaie ME. Iranian version of childbirth self-efficacy inventory. J Clin Nurs. 2008;17:2846-55. doi: 10.1111/j.1365-2702.2008.02385. x.

38. Vaux A, Phillips J, Holly L, Thomson B, Williams D, Stewart D. The social support appraisals (SS-A) scale: Studies of reliability and validity. Am J Commun Psychol. 1986; 14: 195-218. doi:10.1007/BF00911821.

39. Cobb S. Social support as a moderator of life stress. Biopsychosocial Sci Med. 1976; 38: 300-314. doi:10.1097/00006842-197609000-00003.

40. Acoba EF. Social support and mental health: the mediating role of perceived stress. Front Psychol. 2024; 15:1330720. doi: 10.3389/fpsyg.2024.1330720.

41. Kline RB. Methodology in the social sciences. Principles and practice of structural equation modeling (4th ed).2016. New York, NY, US: Guilford Press.

42. Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis.2019.

43. Mallinckrodt B, Abraham WT, Wei M, Russell DW. (2006). Advances in Testing the Statistical Significance of Mediation Effects. J Counsel Psychol. 2006; 53: 372-8. doi:10.1037/0022-0167.53.3.372.

44. Bernad BC, Tomescu MC, Velimirovici DE, Andor M, Lungeanu D, Enătescu V, et al. Health-Related Quality of Life and Anxiety Levels in Pregnant Women with and Without Associated Pathologies. J Clin Med. 2025; 14:6815. doi: 10.3390/jcm14196815.

45. Kowalska J. The Level of Stress and Anxiety in Pregnant Women Depending on Social Support and Physical Activity. J Clin Med. 2023; 12:3143. doi: 10.3390/jcm12093143.

46. Çiçek Ö, Aypar Akbağ NN, Durmazoğlu G, Öztürk Ç. The relationship between fear of childbirth and birth self-efficacy in low and high-risk pregnant women. BMC Pregnancy Childbirth. 2025; 25:1181. doi: 10.1186/s12884-025-08354-w.

47. Acoba EF. Social support and mental health: the mediating role of perceived stress. Front Psychol. 2024; 15:1330720. doi: 10.3389/fpsyg.2024.1330720.

48. Vinje HF, Langeland E, Bull T. Aaron Antonovsky’s Development of Salutogenesis, 1979–1994. 2022 Jan 1. In: Mittelmark MB, Bauer GF, Vaandrager L, Pelikan JM, Sagy S, Eriksson M, Lindström B, Meier Magistretti C, editors. The Handbook of Salutogenesis [Internet]. 2nd ed. Cham (CH): Springer; 2022. Chapter 5.

49. Haugan G, Eriksson M, editors. Health Promotion in Health Care – Vital Theories and Research [Internet]. Cham (CH): Springer; 2021.

50. Donyaei-Mobarrez Y, Rezasoltani P, Rafat F, Kazemnejad Leyli E. Evaluation of childbirth self-efficacy and associated factors among pregnant women. J Educ Health Promot. 2023; 12:330. doi: 10.4103/jehp.jehp_1770_22.

51. Mohammadi F, Kohan S, Farzi S, Khosravi M, Heidari Z. The effect of pregnancy training classes based on bandura self-efficacy theory on postpartum depression and anxiety and type of delivery. J Educ Health Promot. 2021; 10:273. doi: 10.4103/jehp.jehp_105_21.

52. Mancini JA, Blieszner R. Social provisions in adulthood: concept and measurement in close relationships. J Gerontol. 1992;47: P14-20. doi: 10.1093/geronj/47.1.p14.

53. Bahrami-Samani S, Omidvar S, Mohsenzadeh-Ledari F, Azizi A, Ashrafpour M, Kordbagheri M. The relationship between perceived stress and pregnancy distress with self-care of pregnant women: The mediating role of social support-A cross-sectional study. Health Sci Rep. 2023;6:e1730. doi: 10.1002/hsr2.1730.

54. Rohandeh S, Tadayin M, Javad Nouri M, Haqiqi M, Zare Z. Investigating the relationship between social support and mental health in pregnant women in Ahvaz. Jundishapur SciMedical J. 2025; 24: 269-59.

55. Naghizadeh S. Comparison of pregnancy self-care, perceived social support and perceived stress in low-risk and high-risk groups. J Health Care. 2019; 21: 16-25. doi:10.29252/jhc.21.1.16.

56. Gariépy G, Honkaniemi H, Quesnel-Vallée A. Social support and protection from depression: systematic review of current findings in Western countries. Br J Psychiatry. 2016; 209:284-93. doi: 10.1192/bjp.bp.115.169094.

57. Tengku Mohd TAM, Yunus RM, Hairi F, Hairi NN, Choo WY. Social support and depression among community dwelling older adults in Asia: a systematic review. BMJ Open. 2019;9: e026667. doi: 10.1136/bmjopen-2018-026667.

58. Bedaso A, Adams J, Peng W, Sibbritt D. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health. 2021; 18:162. doi: 10.1186/s12978-021-01209-5.

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Tavangar Dehghan M, Sodagar S, Nayebinia A S. The relationship between quality of life and pregnancy anxiety with the mediation of childbirth self-efficacy and social support. J. Ilam Uni. Med. Sci. 2026; 34 (1) :58-71
URL: http://sjimu.medilam.ac.ir/article-1-8852-fa.html

Tavangar Dehghan Mahboubeh، Sodagar Sheida، Nayebinia Anvar Sadat. The relationship between quality of life and pregnancy anxiety with the mediation of childbirth self-efficacy and social support. مجله دانشگاه علوم پزشکی ایلام. 1405; 34 (1) :58-71

URL: http://sjimu.medilam.ac.ir/article-1-8852-fa.html

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