Factors influencing happiness and depression in high-risk pregnant women: a cross-sectional study using the ecological systems approach.

This was a cross-sectional survey, so it cannot show that mindfulness, marital intimacy, social support, stress, happiness or depression cause one another. Participants were recruited by convenience sampling from a single city and an online community, so results may not apply to other settings or populations. The sample was limited to married or common-law women, Korean speakers, and those without diagnosed mental illness or related medication, so findings may not apply to other pregnant women. All measures were self-report questionnaires, and one insincere response was excluded, but social desirability or misreporting could still affect results. The study did not test any intervention or nursing care, so it cannot tell clinicians whether acting on these factors improves outcomes. The article reports a happiness mean of 27.72 in the results but a happiness score of 20.72 in the discussion, so the exact happiness score is unclear. Only selected ecological system variables were measured, and the authors note other relevant factors were not included. The discussion states that COVID-19 visitation restrictions may have affected social support, particularly for hospitalized women.

One author had been an editorial board member of the journal since January 2022 but was not involved in the review process. The authors otherwise reported no conflict of interest. The work was funded by the National Research Foundation of Korea under a grant from the Korean government (MSIT), grant 2022R1A2C1003240.

Do not conclude that mindfulness, marital intimacy, social support or outpatient status will improve happiness or reduce depression. This cross-sectional survey only identified associations and did not test any intervention.