BackgroundFear of childbirth is an important perinatal mental health concern, particularly among women of advanced maternal age. However, the specific interrelations between spousal support and fear of childbirth remain unclear.MethodsThis cross-sectional study recruited 279 pregnant women of advanced maternal age from a tertiary hospital in Henan, China, using convenience sampling. Spousal support and fear of childbirth were assessed using the Spouse Support Inventory and the Childbirth Attitud