Predictor role of COVID-19 anxiety on maternal competency with mediating role of mother-infant attachment: A study of structural equation modeling

INTRODUCTION: COVID-19 pandemic is one of the factors that can increase anxiety and stress levels in pregnant women. Anxiety reduces the maternal-infant attachment. Mother-infant attachment can play an important role in maternal competency. The aim of this study was to predict effect of COVID-19 anxiety during pregnancy and the postpartum period on the maternal competency with mediating role of maternal-infant attachment. METHOD: A prospective longitudinal study was conducted on 253 pregnant women in the third trimester of pregnancy that referred to the health centers of Iran University of Medical Sciences and met the study inclusion criteria. Demographic questionnaire and the COVID-19 anxiety scale completed during the third trimester of pregnancy and after the delivery and Müller's mother-infant attachment and maternal competency questionnaire completed at 48 h and 6 weeks after delivery by self-report method. Smart partial lease square version 3 was used to assess the validity and reliability of the model and the relationship between the variables. RESULTS: The findings of this study demonstrated that the COVID-19 anxiety during postpartum had a significant negative effect on the maternal-infant attachment (β = −0.183). Also, the maternal-infant attachment had a significant positive effect on the maternal competency (β = 0.48). Moreover, the conceptual model had good validity, reliability, quality and fit. And also the two variables of anxiety and mother-infant attachment together explained 25% of maternal competency. DISCUSSION: Mothers experience higher levels of the COVID-19 anxiety during pregnancy and postpartum; therefore, it is recommended that particular attention should be given to the psychological support of pregnant women during the COVID-19 pandemic and quarantine. Also, the COVID-19 anxiety during the postpartum period had a negative effect on the maternal-infant attachment and competency, which necessitates the need for the support of mother-infant relationship and providing the online training to promote the maternal-infant attachment patterns and maternal competency during the COVID-19 pandemic.