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Social Support and Spousal Relationship Quality Improves Responsiveness among Anxious Mothers

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Abstract

Maternal responsiveness, a mother’s ability to consistently identify infant cues and then act on them, is critical for healthy child development. A woman’s social support and spousal relationship may affect responsiveness to an infant, especially among mothers with anxiety. We assessed how social support and spousal relationship quality is associated with responsiveness among anxious mothers, and if postpartum depression (PPD) moderated these associations. Cross-sectional data were collected from 2019 to 2022 in a public hospital in Pakistan from 701 women at six-weeks postpartum. Eligible women had at least mild anxiety in early- to mid- pregnancy. Linear regression analyses assessed if spousal relationship quality and social support from family and friends were associated with maternal responsiveness, measured using the Maternal Infant Responsiveness Instrument. Interaction terms were used to examine if PPD moderated these associations. Spousal relationship quality (B = 2.49, 95% CI: 1.48, 3.50) and social support (B = 1.07, 95% CI: 0.31, 1.83) were positively related to maternal responsiveness to the infant. Emotional support from a spouse was positively associated with responsiveness (B = 1.08, 95% CI: 0.12, 2.03 depressed; B = 2.96, 95% CI: 1.34, 4.58 non-depressed), and conflict with the spouse was negatively associated with responsiveness (B=-1.02, 95% CI: -1.94, -0.09 depressed; B=-2.87, 95% CI: -4.36, -1.37 non-depressed). However, social support was related to responsiveness only in non-depressed women (B = 2.61, 95% CI: 1.14, 4.07). While spousal relationships and social support enhance maternal responsiveness, for depressed women, spousal relationships were particularly critical. In considering maternal-infant interventions to improve child development outcomes, our study indicates the importance of supportive relationships that foster effective responsiveness.

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Data Availability

Data used in this study can be accessed at the US National Institutes of Health, National Institute of Mental Health (NIMH) Data Archive: https://nda.nih.gov/.

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Acknowledgements

We would like to thank the staff, patients and families for their assistance and research participation.

Funding

This study was supported by the US National Institute of Mental Health, grant RO1 MH111859.

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Authors and Affiliations

  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA

    Miranda Bain, Soim Park & Pamela J Surkan

  2. Public Mental Health Department, Health Services Academy, PM Health Complex, Islamabad, Pakistan

    Ahmed Zaidi & Abid Malik

  3. Human Development Research Foundation, Global Institute of Human Development, Shifa Tameer-e-Millat University, Gujar Khan Campus, Near Government Rural Health Center Mandra, Rawalpindi, Pakistan

    Najia Atif & Atif Rahman

  4. Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, 1-5 Dover Street, Liverpool, L69 3GL, UK

    Atif Rahman

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Contributions

Writing - original draft preparation: MB; Formal analysis: SP; Writing - review and editing: SP, PS, NA, AR, AM; Funding acquisition: PS; Data Curation: AZ; Supervision - data collection and assessments: AM; Supervision - intervention delivery: NA.

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Correspondence to Pamela J Surkan.

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This study followed ethical guidelines and obtained human subjects’ approval from Research Ethics Committees at Johns Hopkins Bloomberg School of Public Health, Rawalpindi Medical University, Human Development Research Foundation, and a US NIMH-appointed Data Safety and Monitoring Board.

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Bain, M., Park, S., Zaidi, A. et al. Social Support and Spousal Relationship Quality Improves Responsiveness among Anxious Mothers. Child Psychiatry Hum Dev (2024). https://doi.org/10.1007/s10578-024-01702-5

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