Vol.:(0123456789) 1 3 Community Mental Health Journal https://doi.org/10.1007/s10597-019-00387-8 ORIGINAL PAPER Relationship Between Marital Quality, Social Support and Mental Health During Pregnancy Zahra Alipour 1,5  · Ashraf Kazemi 2  · Gholamreza Kheirabadi 3  · Ahmad‑Ali Eslami 4 Received: 5 May 2018 / Accepted: 1 March 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract The aim of this study was to investigate the relationship between marital quality and mental health during pregnancy. This cross-sectional study was conducted on 300 Iranian pregnant women. The ENRICH marital satisfaction subscales, levels of domestic violence, perceived social support, as well as depression and anxiety levels were assessed using a questionnaire. AMOS path analysis was used to explore the causal relationship and the mediating efect of social support among the vari- ables of marital quality subscales and mental health. The results showed that, adjusted for age, the history of infertility and level of anxiety were related to marital satisfaction, marital relationships and level of depression which were related to the level of domestic violence. Sexual satisfaction and the level of perceived social support had a mediating role in such rela- tionships. The study confrmed that marital quality is an important predictor of mental health. Improving the marital quality may lead to improvement in mental health. Keywords Mental health · Pregnancy · Marital communication · Marital satisfaction · Social support Introduction Mental disorders are common problems (Milgrom et al. 2008; Alipour et al. 2012) and associated with poor mater- nal and fetal consequences, such as increased risk of preec- lampsia (Alder et al. 2007), preterm birth, low birth weight (Ibanez et al. 2012), and postpartum depression (Alipour et al. 2012). Pregnancy and transition to the parental role cause biological, psychological and social changes in women (Gourounti et al. 2012) due to creation of new relationships between couples (Lederman 1990). Parents are often faced with new challenges in this period. Therefore, during pregnancy and after childbirth, they are vulnerable to mental problems (Smith et al. 2011). It is believed that multiple socioeconomic and biological factors afect mental health during pregnancy (Fisher et al. 2012). However, several studies have shown that marital satisfac- tion has a relationship with mental health (Cummings and O’Reilly 1997; Ryan et al. 2005; Lancaster et al. 2010). Provision of support for women continuing pregnancy can in some communities prevent mental issues. In the Ira- nian society, the motherhood roles are considered the most important of the women’s gender roles which infuence the quality of marital life and women’s mental health (Aliak- baridehkordi et al. 2012). In addition, formation of new roles and tasks for the couple during pregnancy may afect the relationship between mental health and couple relationships. Further, social support is related to marital relationships and has an impact on women’s mental health (Qadir et al. 2013). However, there is no clear consensus as to how a combination of marital relations and social support contrib- utes to the infuence of women’s mental health during preg- nancy. Both social support and marital satisfaction are asso- ciated and may be substantial mediators in the mental health * Ashraf Kazemi kazemi@nm.mui.ac.ir 1 Student Research Committee, Schools of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran 2 Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran 3 Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 4 Department of Health Education and Promotion, Isfahan University of Medical Sciences, Isfahan, Iran 5 Department of midwifery, Nursing and Midwifery School, Qom University of Medical Sciences, Qom, Iran