Midwifery · 2026
Perceived social support, fear of childbirth, and maternal-fetal attachment among pregnant women in China: Network and simulation-based analyses.
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Sheng Lei, Liu Xin, Zhang Xinhan, Ren Fengyi, Qin Mengyao, Yuan Miao, Chen Xinxia
Аннотация
AIMS: To examine associations among perceived social support, fear of childbirth, and maternal-fetal attachment (MFA) in pregnant women, and to identify dimension-level interconnections and potential intervention-relevant targets.
METHODS: A cross-sectional study was conducted among 672 pregnant women recruited from three hospitals in China between February 2022 and October 2023. Perceived social support, fear of childbirth, and MFA were assessed using validated questionnaires. Mediation, Gaussian network, and Bayesian network analyses were conducted to examine overall and dimension-level associations. Simulation-based network intervention analysis was subsequently used to examine potential intervention-relevant targets.
RESULTS: Fear of childbirth partly accounted for the association between perceived social support and MFA (β = 0.03, 95% CI [0.01, 0.05]), representing 11.4% of the total association. In the Gaussian network, fear of losing control had the highest node strength, whereas attachment quality had the highest bridge strength. In the Bayesian network, friend support appeared relatively upstream in the probabilistic dependency structure, while family support was more directly connected with dimensions of fear of childbirth and MFA. In the simulated alleviating and aggravating scenarios, family support showed the largest projected decrease in the MFA unfavourable-state score, whereas friend support showed the largest projected increase.
CONCLUSION: Perceived social support, fear of childbirth, and MFA were linked at both total-score and dimension levels. The simulation-based findings further suggested distinct projected roles for family and friend support. These findings may inform individualised antenatal psychosocial assessment by highlighting the need to identify each woman's perceived support needs and salient childbirth-related concerns.
METHODS: A cross-sectional study was conducted among 672 pregnant women recruited from three hospitals in China between February 2022 and October 2023. Perceived social support, fear of childbirth, and MFA were assessed using validated questionnaires. Mediation, Gaussian network, and Bayesian network analyses were conducted to examine overall and dimension-level associations. Simulation-based network intervention analysis was subsequently used to examine potential intervention-relevant targets.
RESULTS: Fear of childbirth partly accounted for the association between perceived social support and MFA (β = 0.03, 95% CI [0.01, 0.05]), representing 11.4% of the total association. In the Gaussian network, fear of losing control had the highest node strength, whereas attachment quality had the highest bridge strength. In the Bayesian network, friend support appeared relatively upstream in the probabilistic dependency structure, while family support was more directly connected with dimensions of fear of childbirth and MFA. In the simulated alleviating and aggravating scenarios, family support showed the largest projected decrease in the MFA unfavourable-state score, whereas friend support showed the largest projected increase.
CONCLUSION: Perceived social support, fear of childbirth, and MFA were linked at both total-score and dimension levels. The simulation-based findings further suggested distinct projected roles for family and friend support. These findings may inform individualised antenatal psychosocial assessment by highlighting the need to identify each woman's perceived support needs and salient childbirth-related concerns.