Objectives This study aimed to determine the association of marital relationships with pregnant women's obstetrical history, physical and psychosocial factors, and characteristics of women and husbands from the perspective of adaptation to pregnancy. Moreover, it sought to offer suggestions regarding support for couples during pregnancy in urban areas.Methods We distributed self-reported questionnaires to pregnant women who participated in antenatal classes, organized by Public Interest Incorporated Foundation A, in four designated cities in the Kansai region of Japan. We investigated women's obstetrical history, physical and psychosocial factors, and characteristics of women and husbands using the Japanese Prenatal Self-Evaluation Questionnaire (Relationship with Husband) (J-PSEQ). Of the 778 women, 413 (53.1%) responded. After applying the exclusion criteria, 388 participants were eligible for analysis (valid response rate: 93.9%). Based on their J-PSEQ scores, participants were divided into two groups: poor marital relationship and normal or good marital relationship. Logistic regression analysis was performed to examine the factors related to the quality of marital relationships from the perspective of adaptation to pregnancy.Results Based on the J-PSEQ scores, 93 (24.0%) participants were categorized into the poor marital relationship group, and 295 (76.0%) were categorized into the normal or good marital relationship group. For the poor marital relationship group, the logistic regression analysis showed that the odds ratios (confidence intervals) for "pregnancy after infertility treatment," "easily angered and irritated," and "husband's health: somewhat poor" were 2.54 (1.38-4.66), 3.55 (1.86-6.78), and 3.54 (1.06-11.87), respectively. Women who described household finances, husbands' working conditions, and lack of support to be the most stressful factors were more likely to have poor marital relationships. The factors associated with normal or good marital relationships included women experiencing physical discomfort, women not engaging in Satogaeri Shussan (staying at women's parents' homes before and after birth), husbands taking paternity leave after childbirth, and husbands having good health.Conclusions This study revealed that the factors associated with poor marital relationships in terms of adaptation to pregnancy were pregnancy after infertility treatment, anger and irritation in women, and poor health of husbands. Healthcare professionals may need to focus more closely on supporting such couples in urban areas during pregnancy.
Keywords: anger; husbands' health; infertility; marital relationships; pregnant women; psychosocial adaptation.