Psychosocial health affects oral health-related quality of life. Pregnancy, as a special time for women, produces significant psychological changes. However, the relationship between mental health during pregnancy and oral health-related quality of life is unclear. The study aims to explore the association between fear of childbirth and investigate the mediating effect of pregnancy anxiety. Using a cross-sectional design, 478 pregnant women were recruited and evaluated using the Fear of Birth Scale, the Pregnancy-Related Anxiety Questionnaire and the Oral Health Impact Profile-14. Multiple linear regressions were performed to evaluate the relationship between fear of childbirth and oral health-related quality of life. PROCESS software was applied to assess the mediating effect of pregnancy anxiety. Both fear of childbirth and pregnancy anxiety were negative correlation with oral health-related quality. Pregnancy anxiety mediated 40% of the association between fear of childbirth and oral health-related quality of life (β = 0.072, SE = 0.030, 95% CI [0.015, 0.131]). Pregnancy anxiety mediates the relationship between fear of childbirth and oral health-related quality of life in pregnant women. To improve the oral health-related quality of life among pregnant women, relevant healthcare workers should actively help pregnant women to improve psychological health.
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