Network analysis of spousal support and fear of childbirth in pregnant women of advanced maternal age.

Background: Fear of childbirth is an important perinatal mental health concern, particularly among women of advanced maternal age. However, the specific interrelations between spousal support and fear of childbirth remain unclear. Methods: This cross-sectional study recruited 279 pregnant women of advanced maternal age from a tertiary hospital in Henan, China, using convenience sampling. Spousal support and fear of childbirth were assessed using the Spouse Support Inventory and the Childbirth Attitude Questionnaire. A regularized partial-correlation network was estimated using EBICglasso, and central and bridge nodes were identified. Network stability was examined using bootstrap procedures. Results: The prevalence of any fear of childbirth, defined as a CAQ score ≥28 and including mild, moderate, and severe categories, was 86.4% (n = 241). Negative associations predominated between the spousal support and fear of childbirth communities. The strongest cross-community association was observed between "teaching you how to do things you do not know how to do" and "concern about fetal health." The most central nodes were "participating in activities together to reduce your stress" and "providing you with helpful information," whereas the strongest bridge nodes were "helping you understand why things did not go well" and "giving you encouragement. Conclusion: Specific supportive behaviors, especially informational and cognitive-appraisal support, occupied central positions in the network linking spousal support and fear of childbirth among pregnant women of advanced maternal age. Strengthening these forms of spousal support may inform the development of couple-based interventions to reduce childbirth fear and promote perinatal mental health.