Factors influencing pregnant women’s intention toward bed-sharing with infant in China: a cross-sectional study

Bed-sharing can have a negative impact on infant sleep safety. In order to reduce the occurrence of bed-sharing with infants, it's necessary to shift the research lens from newborn parents to the antenatal stage before infant birth. Our study aimed to assess the attitudes, subjective norms, perceived behavioral control, and intentions of pregnant women about bed-sharing based on the theory of planned behavior (TPB). This cross-sectional study was conducted with 512 pregnant women in the obstetrics clinic of a tertiary hospital in China using convenience sampling. Data were collected through self-reported questionnaires, consisting of demographic characteristics and a questionnaire for pregnant women on infant sleep safety based on TPB (12 items). Data were analyzed with SPSS 22.0 and AMOS 24.0. Structural equation modeling was carried out to verify the hypothetical model based on TPB. The results showed the average behavior intention score was 9.90 ± 5.14, indicating low intent for bed-sharing among pregnant women post-delivery. The Theory of Planned Behavior model explained 38.7% of the variance in bed-sharing intention, with attitude as the strongest predictor (β = 0.343, <i>p</i> < 0.001), followed by subjective norm (β = 0.232, <i>p</i> < 0.001) and perceived behavioral control (β = -0.210, <i>p</i> < 0.001). This study highlights the importance of antenatal health education and behavioral intervention early in pregnancy based on TPB theory to enhance infant sleep safety and encourage changes in bed-sharing behavior.