Pregnant women showing signs of problematic internet use also reported higher levels of pregnancy-related distress, according to a cross-sectional study of 255 women recruited from healthcare centers in Amol and Babol, Iran. The study, conducted between September 2024 and March 2025, found that 16.4% of participants were classified as being at risk of problematic internet use. However, the researchers emphasize that because of the cross-sectional design, causal relationships cannot be inferred from these associations.
The research team, led by Mojgan Firouzbakht and colleagues, recruited pregnant women with a gestational age of at least 24 weeks using convenience sampling. Participants completed a demographic and obstetric information form along with three validated instruments: Young’s Internet Addiction Test (IAT), the Maternal–Fetal Attachment Scale (MFAS), and the Tilburg Pregnancy Distress Scale (TPDS). The researchers analyzed the data using descriptive statistics, Pearson correlation coefficients, and both univariable and multivariable linear regression analyses performed in SPSS software.
The central finding was a positive correlation between problematic internet use and pregnancy-related distress, with a Pearson coefficient of r = 0.296 (p < 0.001, 95% CI: 0.198 to 0.389, n = 255). In practical terms, women whose IAT scores indicated more problematic engagement with online activities tended to score higher on the measure of pregnancy distress. The correlation is moderate in magnitude, and the confidence interval indicates the estimate is unlikely to reflect random variation alone, though the design cannot establish which factor, if either, drives the other.
The relationship between problematic internet use and maternal–fetal interaction, measured by the MFAS, followed a negative trend but did not reach statistical significance (r = −0.109, p = 0.091). By contrast, pregnancy distress itself was negatively correlated with maternal–fetal interaction (r = −0.262, p < 0.001, 95% CI: −0.373 to −0.127, n = 255), meaning women reporting greater distress tended to report lower maternal–fetal attachment. The authors note that although a negative trend was observed between problematic internet use and maternal–fetal interaction, this association was not statistically significant.
The multivariable regression analysis identified several factors associated with problematic internet use scores. Older age was linked to lower scores (β = −0.213, p = 0.001), while greater daily internet use (β = 0.127, p = 0.042) and mode of delivery (β = 0.129, p = 0.041) were each positively associated with problematic internet use. These regression coefficients are modest, and the study does not establish that any of these characteristics cause changes in internet use patterns; they reflect statistical associations adjusted for the other variables included in the model.
The study’s methods carry limitations worth noting. Convenience sampling from selected healthcare centers in two Iranian cities means the participants may not represent pregnant women more broadly, and the findings cannot be generalized to other populations or settings. All measures were self-reported scales, which are subject to reporting bias. In addition, the cross-sectional design captures a single point in time, so temporal relationships between internet use, distress, and maternal–fetal attachment cannot be determined.
The authors conclude that problematic internet use was associated with higher levels of pregnancy-related distress, while higher pregnancy-related distress was associated with lower maternal–fetal interaction. They frame problematic internet use as one of several factors potentially related to maternal psychological well-being during pregnancy, rather than as a demonstrated cause of poorer outcomes. The article was published open access in BMC Pregnancy and Childbirth on 28 October 2026, and the published version was shared early as a citable, peer-reviewed accepted manuscript subject to further editorial edits before the final Version of Record.
For clinicians and researchers, the study adds to the conversation about how digital engagement intersects with maternal mental health, but it stops short of supporting interventional claims. Because the analysis is observational and correlational, the appropriate interpretation is that problematic internet use, pregnancy distress, and maternal–fetal interaction co-occur in measurable patterns within this sample. Further research, particularly longitudinal or experimental designs in more diverse populations, would be needed to determine whether reducing problematic internet use would affect distress levels or maternal–fetal attachment during pregnancy.
Subject of Research: Associations between problematic internet use, pregnancy-related distress, and maternal–fetal interaction among pregnant women
Article Title: Problematic internet use and its association with pregnancy-related stress and maternal–fetal interaction among pregnant women: a cross-sectional study
Article References: Firouzbakht, M., Omidvar, S., Nikpour, M., & Zare, O. (2026). Problematic internet use and its association with pregnancy-related stress and maternal–fetal interaction among pregnant women: a cross-sectional study. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-026-10156-7
Image Credits: AI Generated
DOI: 10.1186/s12884-026-10156-7
Keywords: problematic internet use, pregnancy distress, maternal-fetal attachment, cross-sectional study, Internet Addiction Test, Tilburg Pregnancy Distress Scale, pregnant women, Iran, maternal mental health, convenience sampling, Problematic, internet
