Predicting pregnancy concerns based on self-confidence, quality of life, and psychological security in nulliparous women

Pregnancy is a significant life transition that may be accompanied by various physical and psychological concerns, particularly among nulliparous women experiencing pregnancy for the first time. Despite the potential importance of psychological and quality-of-life factors, the extent to which self-confidence, quality of life, and psychological security predict pregnancy concerns remains insufficiently understood. Therefore, this study aimed to predict pregnancy concerns based on self-confidence, quality of life, and psychological security among nulliparous women. This was a descriptive-correlational study. The statistical population included nulliparous mothers referring to health centers in western Mazandaran in spring 2025, and 160 women were selected using a convenience sampling method. Data were collected using standard self-report questionnaires assessing self-confidence, quality of life, psychological security, and pregnancy concerns. Pearson correlation and multiple regression (simultaneous model) were used to analyze the data in SPSS-26 ( P < 0.05). The results showed a negative and significant relationship between self-confidence, quality of life, and psychological security with pregnancy concerns in nulliparous women ( r = -0.523, -0.541, and − 0.369 respectively, P < 0.001). Also, the variables of self-confidence, quality of life, and psychological security together significantly predicted 45.6% of the changes in pregnancy concerns (R² = 0.456, F(3,156) = 43.639, P < 0.001); quality of life was the strongest predictor (β = -0.493), followed by self-confidence (β = -0.481) and psychological security (β = 0.167). Based on these findings, family counselors and therapists can design and implement programs to increase self-confidence, quality of life, and psychological security in order to reduce pregnancy concerns in nulliparous women.