Body image dissatisfaction and self-confidence as predictors of happiness in pregnant women in Türkiye: a cross-sectional study

Pregnancy is characterized by substantial physical and psychological changes that may influence women’s perceptions of their bodies and psychological well-being. Body image dissatisfaction and self-confidence are important psychosocial factors that may be associated with happiness during pregnancy. However, studies simultaneously examining the relationships among these variables remain limited. This study aimed to examine the associations of body image dissatisfaction and self-confidence with happiness and to identify factors independently associated with happiness among pregnant women. This cross-sectional study was conducted between August and December 2023 with 164 pregnant women attending the Perinatology Outpatient Clinic of Erciyes University Health Application and Research Center in Kayseri, Türkiye. Data were collected using the Pregnant Woman Information Form, Body Image in Pregnancy Scale (BIPS), Women’s Self-Confidence Scale (WSCS), and Oxford Happiness Questionnaire–Short Form (OHQ-SF). Spearman correlation and hierarchical linear regression analyses were performed. Among the participants, 51.8% were aged 30–35 years and 64.6% had a master’s or doctoral degree. The mean BIPS, OHQ-SF, and WSCS scores were 76.18 ± 18.83, 22.26 ± 3.15, and 140.93 ± 10.90, respectively. Body image dissatisfaction was negatively correlated with happiness ( r = − 0.428, p < 0.001), whereas self-confidence was positively correlated with happiness ( r = 0.288, p < 0.001). In the final hierarchical regression model, greater body image dissatisfaction was associated with lower happiness (β = −0.528, p < 0.001), whereas higher self-confidence (β = 0.174, p = 0.013) and higher educational level (β = 0.191, p = 0.009) were associated with greater happiness. Gestational diabetes mellitus was negatively associated with happiness (β = −0.254, p = 0.003). The final model explained 35.2% of the variance in happiness (R² = 0.352). Body image dissatisfaction was negatively associated with happiness, whereas self-confidence was positively associated with happiness during pregnancy, with body image dissatisfaction showing the strongest association in the multivariable model. These findings highlight the importance of considering body image and self-confidence as components of psychosocial well-being during antenatal care. Given the cross-sectional design, causal relationships cannot be established, and further longitudinal and intervention studies are warranted.