Maternal life events, anxiety, social support, and prenatal depression among pregnant women: a cross-sectional study in Yinchuan, China

While the association between life events and depression has been well-established, the mechanisms linking life events to depression in pregnant women require further exploration. This study aimed to explore the association between maternal life events and depression, with anxiety and social support as potential influencing factors. A cross-sectional study was conducted from January 2020 to December 2021 among 1767 pregnant women recruited via convenience sampling from a tertiary hospital in Yinchuan, China. Participants completed the Patient Health Questionnaire-9 (PHQ-9), Life Events Scale for Pregnant Women (LESPW), Generalized Anxiety Disorder scale (GAD-7), and Social Support Rating Scale (SSRS). Data were analyzed using SPSS 26.0 and PROCESS 3.5. The key findings revealed that: maternal life events were positively associated with depression, with a total effect of 0.323 (95%<i>CI</i> = 0.283-0.363, <i>p</i> < 0.001) and a direct effect of 0.117 (95%<i>CI</i> = 0.084-0.151, <i>p</i> < 0.001). Anxiety partially mediated this association, accounting for 63.8% of the total effect (indirect effect = 0.206, 95%<i>CI</i> = 0.175-0.239, <i>p</i> < 0.001). Social support and its three dimensions negatively influenced the association between maternal life events and anxiety(moderating effects: overall social support <i>β</i>=-0.840, subjective support <i>β</i>=-0.786, objective support <i>β</i>=-0.360, support utilization <i>β</i>=-0.441, all <i>p</i> < 0.01). These findings suggest that maternal life events influence prenatal depression both directly and indirectly, while social support mitigates anxiety triggered by stressors. Targeted interventions to reduce life event exposure and strengthen social support may alleviate anxiety and depression in pregnant women.