Exploring the coping process in pregnant women with autoimmune disease and their spouses: a network analysis of Chinese couples

For women with autoimmune diseases and their spouses, pregnancy and autoimmune disease constitute ongoing stressors that persist throughout gestation, contributing to psychological and physical stress and complicating coping efforts. This study examines dyadic coping among Chinese couples facing autoimmune disorders during pregnancy, using network analysis to map how partners appraise and respond to stress together. An observational cross-sectional study was conducted from March to December 2024. A total of 185 pregnant women with autoimmune diseases and their spouses ( n = 370) were recruited from obstetric outpatient clinics in Nanjing, China. Participants completed online versions of the Brief Illness Perception Questionnaire, Dyadic Coping Inventory, and Dyadic Adjustment Scale. Network models were estimated using Gaussian graphical models with EBICglasso regularization. The individual networks of pregnant women and spouses showed numerical differences in density and global strength; however, network comparison tests did not indicate significant differences in network structure or global strength. Supportive dyadic coping, common dyadic coping, and stress communication were among the most highly connected components in both networks. Pregnant women reported significantly lower dyadic satisfaction and adjustment than their spouses. In dyadic networks, supportive dyadic coping reported by pregnant women showed high centrality and bridge strength. The “No-history” group had numerically lower density and global strength than the “Had-history” group, but neither difference was statistically significant (network structure: P = 0.726; global strength: P = 0.383). This cross-sectional study identified dyadic coping patterns in pregnant women with autoimmune diseases and their spouses, highlighting that supportive coping, common coping, and stress communication were highly connected component of the observed networks. The findings may help generate hypotheses for gender-sensitive dyadic-support approaches. Longitudinal and intervention studies are also needed before clinical effectiveness can be inferred.