Romantic Relationship Quality and Mental Health in Pregnancy During the Covid-19 Pandemic

Introduction: Social capital is important for good mental health and the quality of close relationships is one key indicator of social capital. Examining the association between relationship quality and mental health may be particularly important during pregnancy as mental health concerns during this period pose significant risk to families. The COVID-19 pandemic has contributed to increased mental health problems among pregnant individuals. The resulting lockdown protocols of the pandemic have also disrupted larger social networks and couples spent more time together in the context of ongoing chronic stress, highlighting the particular importance of romantic relationship quality. This study explored longitudinal associations between relationship satisfaction, depression, and anxiety among pregnant individuals during the first wave of the COVID-19 pandemic. Methods: Pregnant individuals (n = 1842) from the Pregnancy During the Pandemic Study were surveyed monthly (April-July 2020). Depression, anxiety symptoms, and relationship satisfaction were self-reported. Cross-lagged panel models were conducted to examine bidirectional associations between relationship satisfaction and mental health symptoms over time. Results: Relationship satisfaction was significantly correlated with depression and anxiety at all time points. Longitudinally, relationship satisfaction predicted later depression and anxiety symptoms, but depression and anxiety symptoms did not predict later relationship satisfaction. Discussion: This study suggests that poor relationship satisfaction was linked to subsequent elevations in prenatal depressive and anxiety symptoms during the COVID-19 pandemic. Relationship enhancement interventions during pregnancy may be a means of improving the mental health of pregnant individuals, and interrupting transgenerational transmission, during times of prolonged psychological distress.