Unpacking the Protective Power of Social Support in Mitigating Prenatal Anxiety Among Low-Resourced Populations: A Mixed-Methods Study.

Background: Anxiety during pregnancy is a prevalent but underemphasized mental health concern with downstream impacts on the entire family unit. Quality social support is strongly related to mental well-being and provides a promising strategy to prevent and manage prenatal anxiety. Methods: This convergent mixed-methods study used a cross-sectional survey and interviews to: (1) Quantitatively investigate what adverse social determinants of health and multi-level sources of social support are most predictive of prenatal anxiety and (2) Qualitatively examine different types of social support that may buffer prenatal anxiety among a sample of pregnant women experiencing socioeconomic disadvantage. Results: Hierarchical linear regressions revealed that race and food insecurity were predictive of prenatal anxiety and that social support from friends/peers was most protective against prenatal anxiety. Integration of quantitative survey data and qualitative interview data suggested that emotional support was most protective among this sample of pregnant women. Discussion: The results of this study highlight opportunities for adaptations of prenatal peer support programs to include a focus on mitigating food insecurity and promoting emotional support from peers in order to most effectively buffer prenatal anxiety among underresourced pregnant women.