ArticleBirth (Berkeley, Calif.)2026
Effect of Anxiety on Depression in Pregnant Women: The Mediating Role of Stress and Moderating Role of Social Support.
Article in Birth (Berkeley, Calif.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough anxiety is a well-established risk factor for depression during pregnancy, the mechanisms through which prenatal anxiety affects depression remain unclear. This study aims to investigate: (a) whether perceived stress acts as a mediator between anxiety and depression, and (b) whether social support plays a moderating role in this relationship.
methodThis cross-sectional study used a questionnaire-based design. Between April 2022 and June 2023, we surveyed pregnant women in their second trimester, collecting 521 valid questionnaires. The survey measured perceived stress, social support, depression, anxiety, as well as demographic characteristics. Data were processed and analyzed using SPSS 26.0 and PROCESS 4.1.
resultAnxiety was significantly associated with depression (β = 0.42, p < 0.001), and perceived stress mediated this relationship (β = 0.13, p < 0.001). Social support significantly moderated the effect of anxiety and depression, influencing both indirect (β = -0.25, p < 0.001) and direct pathways (β = -0.16, p < 0.001). Specifically, anxiety affected perceived stress and depression at both high and low levels of social support, but the effects were attenuated at higher levels of social support for perceived stress (simple slope = 0.11 vs. 0.37) and depression (simple slope = 0.3 vs. 0.47).
conclusionAnxiety not only directly served as a risk factor for depression but also indirectly contributed to depression through perceived stress. Social support moderated both the initial (anxiety → perceived stress) and direct (anxiety → depression) paths of this mediation. Early screening and targeted interventions for anxiety-particularly among pregnant women experiencing high perceived stress and low social support-may help reduce the risk of depression.
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