Modeling Structural Equations in the Relationship Between Marital Conflicts and Emotional Security With Perceived Stress and Prenatal Concerns With Psychological Well-Being in Pregnant Women

Pregnancy is a phenomenon that affects and changes many aspects of women's life, leading to psychological and biological crises and emotional transformation. In an extremely optimistic view, pregnancy is a period in which mothers achieve a range of interesting feelings of well–being and psychological strength. On the other hand, it is a relatively natural event and a largely positive growth experience. Although this personal experience fluctuates over a positive to negative spectrum, pregnancy potentially has important short–term and long–term implications for women's health, well–being, and social roles. Pregnancy issues are important. During pregnancy, a woman's mental health is influenced by factors, such as her feelings about femininity, marital life, husband's family, and agreements and conflicts, sex, and willingness to have a baby. Pregnancy is often a stressful period with physiological and psychological changes, and these problems will have a significant impact on their mental state. This study aimed to model structural equations to explain the relationship between marital conflicts and emotional security with perceived stress and prenatal concerns about psychological well–being in pregnant women experiencing their first pregnancy.

The present study was correlational and of structural equation modeling type. This study's statistical population consisted of pregnant women referred to obstetrics and gynecology clinics and Ramsar Hospital (Ramsar City, Iran) whose pregnancy duration was between four and six months. According to the statistics, about 1400 pregnant women were referred to these centers from February to March 2019. The sample group consisted of 384 pregnant women between 4 and 6 months of gestation selected by simple random sampling using a lottery. In selecting the sample size, 10 to 15 people were needed for each obvious variable. So, 300 people were needed, but 384 people were selected by the purposeful sampling method for more confidence. The inclusion criteria were as follows: having at least a middle school education, having an age between 20 and 45 years, being pregnant women with the experience of the first pregnancy, having a normal pregnancy, being single–birther, and lack of a history of neurological and mental illness and hospitalization. Data collection tools were the Marital Conflict Questionnaire (Sanaei et al., 2000), Psychological Well–Being Scale (Ryff, 1989), Prenatal Distress Questionnaire (Alderdice & Laynne, 2011), Perceived Stress Scale (Cohen et al., 1983), and Intimate Safety Scale (Cordova et al., 2005). Data analysis was done using the Chi–square test and structural equation modeling in AMOS version 22 and SPSS version 22 software. The significance level of the tests was 0.05.

The results showed that marital conflicts (β=–0.48, p=0.002) and emotional security (β=0.37, p=0.013) had a direct and significant effect on psychological well–being. Psychological well–being had a direct and significant effect on perceived stress (β=–0.65, p=0.013) and pregnancy concerns (β=–0.39, p=0.006). Also, the indirect effect of psychological well–being in the relationship between marital conflicts and perceived stress was equal to 0.124 (p=0.014) and the indirect effect of psychological well–being in the relationship between emotional security and perceived stress was equal to 0.036 (p=0.031). The indirect effect of psychological well–being in the relationship between marital conflicts and pregnancy concerns is equal to 0.108 (p=0.019), and the indirect effect of psychological well–being in the relationship between emotional security and pregnancy concerns is equal to 0.201 (p=0.010) Obtained. Also, the goodness of fit indices supported the good fit of the model with the collected data (X2/df=1.90, GFI=0.98, CFI=0.95, AGFI=0.98, RMSEA=0.067).

Based on the findings, marital conflicts and emotional security with the mediation of psychological well–being have a predictive role in the perceived stress and worry during pregnancy of pregnant women.