The effect of perceived stress on spousal support and paternal and maternal attachment in high-risk pregnant women: a path analysis study.

backgroundThe psychological changes experienced by high-risk pregnant women and their partners during this challenging period have not been adequately described. This study aimed to examine the relationship between perceived stress, spousal support, and paternal and maternal attachment among high-risk pregnant women and determine the factors affecting these attachments.

methodsThis descriptive and analytical study included 284 high-risk pregnant women who applied to the perinatology clinic of a state university hospital at 20 weeks of gestation or later and their spouses. Data were collected using a participant information form, the Risky Pregnancy Perceived Stress Scale, the Perception of Spousal Support in Pregnant Women Scale, the Prenatal Attachment Inventory, and the Paternal Antenatal Attachment Scale. Descriptive tests were used for data analysis, and path analysis was performed to explore the effect of the scales and their subscales on each other.

resultsA one-unit increase in the quality of attachment resulted in a 0.272-unit increase in the cognitive dimension, a 0.189-unit increase in the emotional dimension, and a 0.148-unit increase in the material dimension (p = 0.016; p = 0.005; p = 0.007). A one-unit increase in the emotional dimension caused a 0.509-unit decrease in the sociocultural, developmental, and spiritual dimensions (p = 0.010). As prenatal attachment increased, the quality of attachment and time spent in attachment mode increased by 0.177 and 0.125 units, respectively (p = 0.002; p = 0.033). A one-unit increase in paternal attachment led to a 0.338-unit increase in perception of spousal support and a one-unit increase in perception of spousal support led to a 0.296-unit decrease in stress (p < 0.001; p = 0.004).

conclusionsThis study demonstrated that the level of spousal support perceived by pregnant women increased as the level of prenatal paternal attachment increased, that increased spousal support reduced the stress level, and that the level of paternal attachment increased as the attachment level of pregnant women increased. The study findings highlight factors that influence maternal and paternal well-being in high-risk pregnancies from psychological, contextual, and causal perspectives, while addressing the multifaceted nature of prenatal attachment. Future research may explore how the interaction between these factors is shaped within the context of healthcare, cultural, and environmental factors.