Problematic internet use and its association with pregnancy-related stress and maternal–fetal interaction among pregnant women: a cross-sectional study

With the rapid expansion of internet use, problematic engagement with online activities during pregnancy has emerged as a growing concern for maternal psychological well-being. This study aimed to examine the association of problematic internet use with pregnancy-related distress and maternal–fetal interaction among pregnant women. This cross-sectional study was conducted from September 2024 to March 2025 in selected healthcare centers in Amol and Babol, Iran. A total of 255 pregnant women with a gestational age of ≥ 24 weeks were recruited using convenience sampling. Data were collected using a demographic and obstetric information form, Young’s Internet Addiction Test (IAT), the Maternal–Fetal Attachment Scale (MFAS), and the Tilburg Pregnancy Distress Scale (TPDS). Descriptive statistics, Pearson correlation coefficients, and univariable and multivariable linear regression analyses were performed using SPSS software. Overall, 16.4% of participants were classified as being at risk of problematic internet use. Problematic internet use was positively associated with pregnancy-related distress ( r = 0.296, p < 0.001,95%CI: 0.198 to 0.389, n = 255) and its correlation with maternal–fetal interaction was negative but did not reach statistical significance ( r =-0.109, p = 0.091). Pregnancy distress was also negatively correlated with maternal–fetal interaction ( r =-0.262, p < 0.001, 95%CI %: -0.373 to -0.127, n = 255). Multivariate regression analysis showed that older age was associated with lower problematic internet use scores (β = −0.213, p = 0.001), whereas greater daily internet use (β = 0.127, p = 0.042) and mode of delivery (β = 0.129, p = 0.041) were positively associated with problematic internet use. Problematic internet use was associated with higher levels of pregnancy-related distress, while higher pregnancy-related distress was associated with lower maternal–fetal interaction. Although a negative trend was observed between problematic internet use and maternal–fetal interaction, this association was not statistically significant. Given the cross-sectional design, causal relationships cannot be inferred. The findings highlight the need to consider problematic internet use as one of several factors potentially related to maternal psychological well-being during pregnancy.