The Association of Spousal Relationship Quality and Social Support With Maternal-Infant Bonding: Moderating Roles of Maternal Age and Paternal Occupation

This study examined associations between spousal relationship quality and social support with mother-infant bonding among women in Rawalpindi, Pakistan (Intervention Arm: n = 352, M_age = 25.1, SD = 4.7; Control Arm: n = 358, M_age = 25.3, SD = 4.5). We used cross-sectional data from the Happy Mother-Healthy Baby intervention study, a randomized controlled trial conducted between 2019 and 2022. Women were enrolled at their first prenatal visit (at or before 22 weeks of gestation) and followed until 6-week postpartum. Spousal relationship quality, social support, and bonding were assessed at 6-week postpartum. Linear regression analyses found relationship quality (b = 3.85) and social support (b = 1.99) were positively associated with bonding. Analyses were adjusted for mother's education, treatment group, exposure to perinatal intimate partner violence, postpartum depressive symptoms, husband's education, husband's occupation, infant birthweight, and preterm birth. Husband's occupation (unskilled/unemployed vs. professional/skilled) significantly moderated the relationship between social support (b = 3.27 vs. b = 1.37) and relationship quality (b = 5.36 vs. b = 2.95) with bonding. Maternal age (≤ 25 years old vs. > 25 years old) significantly moderated the association between relationship quality and bonding (b = 4.96 vs. b = 2.49). Results suggest that interventions focused on improving social support and relationship quality among anxious women and their spouses could improve maternal-infant bonding. Trial Registration: ClinicalTrials.gov NCT03880032; https://clinicaltrials.gov/ct2/show/NCT03880032.