The Impact of Perceived Social Support During Pregnancy on Postpartum Infant-Focused Anxieties: A Prospective Cohort Study of Mothers in Northern Jordan

Figures & data

Figure 1 Participant flowchart.

Table 1 Factor Loadings For the Rotated Factor Solution for the MOS-SSS Items

Item description	Component
	1	2	3
Emotional support from your close social network (i.e., husband, first-degree relatives, and close friends)
Someone in your close social network makes you feel wanted.	0.01	0.92	0.04
You can turn to someone in your close social network for suggestions about how to deal with a personal problem.	0.06	0.71	-0.03
You can share your most private worries and fears with someone in your close social network.	0.16	0.71	0.01
Someone in your close social network understands your problems.	-0.07	0.69	0.08
You can count on someone in your close social network to listen to you when you need to talk.	-0.18	0.64	0.10
Someone in your close social network shows you love and affection.	0.22	0.62	-0.13
Informational support from healthcare providers (i.e., doctors and nurses)
Your healthcare providers offer you advice when you really want it.	0.91	0.07	-0.08
Your healthcare providers give you information to help you understand a situation related to pregancny and childbirth.	0.88	0.13	-0.11
Your healthcare providers give you good advice about your worries and fears.	0.75	-0.03	0.16
Your healthcare providers make you feel confident when you talk to them about yourself or your problems.	0.72	0.06	0.12
Tangible support from your social network (i.e., husband, first-degree relatives, and close friends)
Someone in your close social network spends time with you.	-0.08	0.06	0.94
Someone in your close social network takes you to the doctor if you need it.	-0.08	0.14	0.87
Someone in your close social network prepares your meals if you are unable to do it yourself.	0.18	-0.06	0.76
Someone in your close social network helps you with daily chores if you are sick.	0.35	-0.13	0.62
Someone in your close social network engages with you to help get your mind off things.	0.50	-0.03	0.55
Someone in your close social network helps you if you are confined to bed.	0.49	-0.02	0.54
Someone in your close social network gets together with you to relax.	0.46	0.03	0.56
Someone in your close social network does something enjoyable with you.	0.49	-0.03	0.56
% of variance explained	44.42	15.73	7.52
Cumulative % of variance	44.42	60.15	67.67
Cronbach’s alpha	0.82	0.89	0.92

Note: significant loadings in boldAbbreviation: MOS-SSS, medical outcomes study social support survey.

Table 2 Baseline Characteristics of the Sample Population (N = 419)

Variable	n (%)	Mean; SD
Mother age (years)
≤ 23	110 (26.3)	29.44; 6.84
24–31	154 (36.8)
32–39	118 (28.1)
≥40	37 (8.8)
Education (years)
≤6	10 (2.4)	12.06; 2.68
7–9	60 (14.3)
10–12	218 (52)
>12	131 (31.3)
Employment status
Unemployed	321 (76.6)	–
Employed	98 (23.4)
Adequate financial resources
No	323 (77.1)	–
Yes	96 (22.9)
Parity
First child	127 (30.3)	–
Multiple children	292 (69.7)
Intention of pregnancy
Unplanned	237 (56.6)	–
Planned	182 (43.4)
Previous pregnancy loss or death of an infant
No	339 (80.9)	–
Yes	80 (19.1)
Mode of birth
Normal	288 (68.7)	–
Caesarian	131 (31.3)
Infant gender
Male	180 (43)	–
Female	239 (57)
Mode of feeding^a
Non-exclusive breastfeeding	304 (72.6)	–
Exclusive breastfeeding	115 (27.4)
Infant age^b
<3 months	186 (44.4)	–
3–6 months	233 (55.6)
Infant mood
Quiet	100 (23.9)	–
Changeable	130 (31.0)
Anxious	189 (45.1)
Infant sleep pattern^c
Sleepless night	105 (25)	–
Little sleep	95 (22.7)
Good sleep	219 (52.3)

Note: ^aInfant age was calculated in months based on the date of each month following the month the baby was born. ^bExclusive breastfeeding means that the infant was fed only breast milk with no solids or other oral intake, except vitamins, mineral supplements, or medication. Otherwise, the feeding mode was defined as non-exclusive breastfeeding. ^cThe infant sleep pattern variable was classified based on the quality of sleep: sleepless night (i.e., if the baby had frequent and prolonged nocturnal awakenings), little sleep (i.e., if the baby had frequent nocturnal awakenings), and good sleep (i.e., if the baby had uninterrupted sleeping at night).

Table 3 Numerical Summary of Anxiety Scores Across the 419 Postpartum Women

Scale Item	Mean	Standard deviation	Skewness	Kurtosis
Infant Safety and Welfare Anxieties
I have felt frightened when my baby is not with me	3.51	0.68	-1.40	2.03
I have repeatedly checked on my sleeping baby	3.49	0.65	-1.35	2.28
I have worried that my baby will stop breathing while sleeping	2.97	0.93	-0.77	-0.16
I have worried about my baby being accidentally harmed by someone or something else	2.13	0.89	0.10	-1.10
I have worried about leaving my baby in a childcare setting	2.89	0.56	-0.62	2.95
I have worried about accidentally harming my baby	2.13	0.90	0.16	-0.95
I have thought of ways to avoid exposing my baby to germs	2.99	0.50	-0.14	3.32
I have not taken part in an everyday activity with my baby because I fear they may come to harm	2.72	0.72	-0.04	-0.33
I have worried about my baby’s health even after reassurance from others	2.75	0.76	-0.72	0.62
I have worried that I will become too ill to care for my baby	2.82	0.45	-1.04	2.88
I have felt a greater need to do things in a certain way or order than before my baby was born	2.93	0.54	-0.43	1.61
Practical Infant Care Anxieties
I have worried about my baby’s milk intake	2.75	0.71	-0.05	-0.30
I have worried about my baby’s weight	2.87	0.54	-0.92	2.49
I have worried about getting my baby into a routine	2.75	0.71	-0.05	-0.30
I have worried about the way that I feed my baby	1.43	0.79	1.91	2.92
I have worried about the length of time that my baby sleeps	2.38	0.90	0.17	-0.71
I have used the internet for reassurance about my baby’s health	1.70	1.09	1.25	0.01
I have worried that my baby is not developing as quickly as other babies	1.62	1.02	1.43	0.62

Note: Mothers reported the frequency of experiencing each feeling on a scale ranging from 1 (not at all) to 4 (almost always). Higher scores on each four-point Likert scale item show higher levels of postpartum infant-focused anxieties.

Table 4 Estimated MLR Coefficients for the Total Scores of Infant Safety and Welfare Anxieties

Variable	B	Standard error	β	p-Value
Sociodemographic Characteristics
Mother age in years	0.02	0.02	0.03	.38
Years of education	0.05	0.06	0.03	.43
Employment status: (Unemployed) Employed	0.09	0.34	0.01	.80
Adequate Financial Resources: (No) Yes	-0.22	0.26	-0.02	.41
Obstetric Characteristics
Parity: (First child) Multiple children	0.02	0.30	0.003	.94
Intention of pregnancy: (Unplanned) Planned	-0.09	0.24	-0.01	.72
Previous pregnancy loss or death of an infant: (No) Yes	0.70	0.34	0.07	.04
Mode of birth: (Normal) Caesarian	0.30	0.23	0.04	.20
Infant Factors
Infant gender: (male) Female	0.13	0.21	0.02	.54
Mode of feeding: (Non-exclusive breastfeeding) Exclusive breastfeeding	-0.58	0.27	-0.07	.03
Infant age: (<3 months) 3-6 months	-0.60	0.23	-0.08	.01
Infant mood: (Quiet)
Changeable	0.64	0.29	0.08	.03
Anxious	1.43	0.30	0.19	<.01
Infant sleep pattern: (sleepless night)
Little sleep	-0.53	0.35	-0.06	.13
Good sleep	-0.29	0.33	-0.04	.39
Social Support Factors
Total score of tangible support received from close social networks	0.04	0.04	0.06	.26
Total score of informational support received from health care providers	-0.96	0.08	-0.71	<.01
Total score of emotional support received from close social networks	-0.08	0.03	-0.08	.01
Model summary
R Square	.71
Adjusted R Square	.70

Note: The reference category is in parentheses.Abbreviation: MLR, multivariate linear regression

Table 5 Estimated MLR Coefficients for the Total Scores of Practical Infant Care Anxieties

Variable	B	Standard error	β	p-Value
Sociodemographic Characteristics
Mother age in years	-0.05	0.02	-0.10	.01
Years of education	0.15	0.06	0.10	.02
Employment status: (Unemployed) Employed	-0.67	0.37	-0.07	.07
Adequate Financial Resources: (No) Yes	0.27	0.28	0.03	.34
Obstetric Characteristics
Parity: (First child) Multiple children	-0.81	0.32	-0.10	.01
Intention of pregnancy: (Unplanned) Planned	-0.86	0.26	-0.11	<.01
Previous pregnancy loss or death of an infant: (No) Yes	2.05	0.37	0.21	<.01
Mode of birth: (Normal) Caesarian	0.57	0.25	0.07	.02
Infant Factors
Infant gender: (male) Female	0.28	0.23	0.04	.22
Mode of feeding: (Non-exclusive breastfeeding) Exclusive breastfeeding	2.40	0.29	0.27	<.01
Infant age: (<3 months) 3-6 months	-1.16	0.25	-0.15	<.01
Infant mood: (Quiet)
Changeable	0.01	0.32	0.001	.97
Anxious	-0.20	0.33	-0.03	.55
Infant sleep pattern: (sleepless night)
Little sleep	-0.42	0.39	-0.05	.27
Good sleep	-2.47	0.37	-0.32	<.01
Social Support Factors
Total score of tangible support received from close social networks	0.09	0.04	0.13	.02
Total score of informational support received from health care providers	-0.28	0.09	-0.20	<.01
Total score of emotional support received from close social networks	-0.03	0.03	-0.03	.30
Model summary
Square	.67
Adjusted R Square	.65

Note: The reference category is in parentheses.Abbreviation: MLR, multivariate linear regression