Predictors of emotional distress in pregnant women: the mediating role of relationship intimacy

Abstract

Emotional distress is common in mid and late trimester antenatal clinic attendees. Furthermore, assessment and treatment of emotional distress during pregnancy show that worries and relationship with the partner are important factors determining psychological health. This study aimed to investigate the impact of worries during pregnancy, relationship intimacy, and marital satisfaction on anxiety, depression and stress symptoms in pregnant women, after controlling for the effects of demographic and obstetric variables, as well as to analyse the mediating effect of relationship intimacy between marital satisfaction and emotional distress. Two hundred women were recruited from childbirth preparation consultation in primary health care settings in the north of Portugal. They provided self-report data during their second and third trimester of pregnancy about worries during pregnancy (Cambridge Worry Scale), relationship intimacy (Personal Assessment of Intimacy in Relationships Scale), marital satisfaction (Marital Satisfaction Scale), and emotional distress (Depression, Anxiety, and Stress Scales). Emotional distress was positively associated with worries during pregnancy, while relationship intimacy and marital satisfaction were inversely related with emotional distress. Being unemployed or with a sick leave, being younger, having a history of miscarriage, having more worries during pregnancy and low relationship intimacy were the most important predictors of emotional distress in pregnant women. The models showed the combined influences of demographic/obstetric, individual, and relationship factors on symptoms of anxiety, depression and stress. Relationship intimacy mediated the relation between marital satisfaction and anxiety/depression. The findings support a recommendation that antenatal services consider integrating screening for emotional distress in routine antenatal care.