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Background <p>Pregnancy is a critical period for emotional adjustment in expectant couples. Antenatal depression in pregnant women is associated with significant risks to maternal and infant health and warrants research attention. The mental health of expectant fathers during this period, which is equally important, remains relatively overlooked. Antenatal stress and marital satisfaction may be associated with antenatal depression through interpersonal dynamics within couples. This study examined the relationships among antenatal stress, marital satisfaction, and antenatal depression within the couple dyad, and tested whether marital satisfaction mediates this association.</p> Methods <p>This cross-sectional study enrolled 244 couples at a maternal and child health hospital in China. Participants completed the Perceived Stress Scale, Edinburgh Postnatal Depression Scale, and Quality of Marriage Index. The Actor-Partner Interdependence Model extended to Mediation was employed to analyze dyadic data, assessing both actor and partner effects. Structural equation modeling with bootstrap resampling was used to estimate direct and indirect effects.</p> Results <p>Significant gender differences were found in antenatal stress, marital satisfaction, and antenatal depression (<i>P</i> &lt; 0.001), with pregnant women reporting higher levels. The APIMeM revealed significant actor effects: individuals’ antenatal stress was positively associated with their own depression (β = 0.361, <i>P</i> &lt; 0.001) and negatively associated with their own marital satisfaction (β=-0.065, <i>P</i> = 0.008). Individuals’ marital satisfaction was negatively associated with their own depression (β=-0.116, <i>P</i> &lt; 0.001). A significant partner effect was observed between individuals’ stress and partners’ depression (β = 0.048, <i>P</i> = 0.009). Marital satisfaction mediated the actor effect of stress on depression in wives (indirect effect β = 0.008, <i>P</i> = 0.005) but not in husbands. Additionally, marital satisfaction significantly mediated the partner effect of husbands’ stress on wives’ depression (indirect effect β = 0.005, <i>P</i> = 0.023).</p> Conclusions <p>Individual antenatal stress was directly associated with both one’s own and one’s spouse’s antenatal depression (actor and partner effects). Marital satisfaction was associated with the actor effect of antenatal stress on depression for wives, as well as the partner effect of husbands’ stress on wives’ depression. These findings suggest that early identification of stressors, promotion of positive marital interactions, and attention to emotional exchanges between partners are relevant to better antenatal mental health outcomes.</p>

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Antenatal stress, marital satisfaction and antenatal depression of Chinese couples: an actor-partner interdependence model extended to mediation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月19日

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  • Yuting Dong,
  • Xiaoqing Liu,
  • Xingyan Xu,
  • Jinying Luo,
  • Shiqiong Liu,
  • Hang Zeng,
  • Xiaowan Zhou,
  • Yang Song,
  • Huangyuan Li,
  • Siying Wu,
  • Shaowei Lin

摘要

Background

Pregnancy is a critical period for emotional adjustment in expectant couples. Antenatal depression in pregnant women is associated with significant risks to maternal and infant health and warrants research attention. The mental health of expectant fathers during this period, which is equally important, remains relatively overlooked. Antenatal stress and marital satisfaction may be associated with antenatal depression through interpersonal dynamics within couples. This study examined the relationships among antenatal stress, marital satisfaction, and antenatal depression within the couple dyad, and tested whether marital satisfaction mediates this association.

Methods

This cross-sectional study enrolled 244 couples at a maternal and child health hospital in China. Participants completed the Perceived Stress Scale, Edinburgh Postnatal Depression Scale, and Quality of Marriage Index. The Actor-Partner Interdependence Model extended to Mediation was employed to analyze dyadic data, assessing both actor and partner effects. Structural equation modeling with bootstrap resampling was used to estimate direct and indirect effects.

Results

Significant gender differences were found in antenatal stress, marital satisfaction, and antenatal depression (P < 0.001), with pregnant women reporting higher levels. The APIMeM revealed significant actor effects: individuals’ antenatal stress was positively associated with their own depression (β = 0.361, P < 0.001) and negatively associated with their own marital satisfaction (β=-0.065, P = 0.008). Individuals’ marital satisfaction was negatively associated with their own depression (β=-0.116, P < 0.001). A significant partner effect was observed between individuals’ stress and partners’ depression (β = 0.048, P = 0.009). Marital satisfaction mediated the actor effect of stress on depression in wives (indirect effect β = 0.008, P = 0.005) but not in husbands. Additionally, marital satisfaction significantly mediated the partner effect of husbands’ stress on wives’ depression (indirect effect β = 0.005, P = 0.023).

Conclusions

Individual antenatal stress was directly associated with both one’s own and one’s spouse’s antenatal depression (actor and partner effects). Marital satisfaction was associated with the actor effect of antenatal stress on depression for wives, as well as the partner effect of husbands’ stress on wives’ depression. These findings suggest that early identification of stressors, promotion of positive marital interactions, and attention to emotional exchanges between partners are relevant to better antenatal mental health outcomes.