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Canlı A, Demirtaş B. Prenatal Attachment and the Relationship With Body Self-Perception. J Obstet Gynecol Neonatal Nurs 2021; 51:e1-e12. [PMID: 34592162 DOI: 10.1016/j.jogn.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To explore prenatal attachment by sociodemographic and obstetric characteristics and to determine the relationship between prenatal attachment and body self-perception among pregnant women. DESIGN Descriptive correlational. SETTING The obstetrics and gynecology outpatient clinic of a university hospital in Ankara, Turkey. PARTICIPANTS One hundred eighty-three healthy pregnant women at 20 weeks or more of pregnancy who visited the obstetrics and gynecology outpatient clinic of the university hospital between April 3 and July 6, 2019. METHODS We collected data using a personal data collection form, the Prenatal Attachment Inventory (PAI), and the Multidimensional Body Self Relations Questionnaire. RESULTS Participants' mean PAI score was 67.74 (SD = 9.98). Participants younger than 20 years had the lowest mean PAI score of 57.20 (SD = 10.66). The level of prenatal attachment decreased as the number of pregnancies increased (p < .05). Participants' mean PAI score had a weak positive relationship with their total body self-perception score (r = .226) and the Appearance Evaluation, Fitness Evaluation, Health Orientation, Fitness Orientation, and Body Areas Satisfaction subscales (p < .05). CONCLUSION Prenatal attachment levels were greater if participants were pleased with their appearances and bodies, approached their physical fitness positively, and engaged in practices to increase their health and physical capacity. We recommend conducting education programs concentrating on adaptation to pregnancy that enable women to evaluate their bodies more positively during pregnancy, to adopt behaviors to improve their health in pregnancy, and to increase prenatal attachment.
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Hildingsson I, Nilsson J, Merio E, Larsson B. Anxiety and depressive symptoms in women with fear of birth: A longitudinal cohort study. Eur J Midwifery 2021; 5:32. [PMID: 34396062 PMCID: PMC8328228 DOI: 10.18332/ejm/138941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Anxiety and depression during pregnancy could imply difficulties in the attachment to the unborn baby. The objective of this study was to investigate the prevalence and change in anxiety and depressive symptoms in pregnant women with fear of birth. Another aim was to explore associations between symptoms of anxiety and depression on prenatal attachment. METHODS This is a longitudinal cohort study of 77 pregnant women with fear of birth in three hospitals in Sweden. Data were collected by three questionnaires in mid and late pregnancy and two months after birth. RESULTS Anxiety symptoms were more often reported than depressive symptoms, significantly decreasing over time in both conditions. Anxiety symptoms were associated with low education level, negative feelings towards the upcoming birth, and levels of fear of birth. Depressive symptoms were associated with levels of fear of birth. One in five women presented with fear of birth, anxiety, and depressive symptoms, suggesting that co-morbidity was quite common in this sample. Depressive symptoms and co-morbidity were negatively associated with prenatal attachment. CONCLUSIONS This study shows that symptoms of anxiety and depression in women with fear of birth vary over time and that co-morbidity is quite common. Lack of emotional well-being was related to prenatal attachment. Healthcare professionals must identify and support women with anxiety and depressive symptoms and fear of birth so that difficulties in the relationship between the mother and the newborn baby might be reduced.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Johanna Nilsson
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Elida Merio
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Birgitta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden.,Department of Health Promoting Science, Sophiahemmet University College, Stockholm, Sweden
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Ertmann RK, Bang CW, Kriegbaum M, Væver MS, Kragstrup J, Siersma V, Wilson P, Lutterodt MC, Smith-Nielsen J. What factors are most important for the development of the maternal-fetal relationship? A prospective study among pregnant women in Danish general practice. BMC Psychol 2021; 9:2. [PMID: 33397501 PMCID: PMC7784374 DOI: 10.1186/s40359-020-00499-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background Development of the maternal antenatal attachment (MAA) constitutes an important aspect of the transition into motherhood. Early identification of women at risk of developing a poor MAA provides possibilities for preventive interventions targeting maternal mental health and the emerging mother-infant relationship. In this study, we investigate the relative importance of an extensive set of psychosocial, pregnancy-related, and physiological factors measured in the first trimester of pregnancy for MAA measured in third trimester. Methods A prospective study was conducted among pregnant women in Danish general practice (GP). Data were obtained in the first and the third trimester from pregnancy health records and electronic questionnaires associated with routine GP antenatal care visits. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal antenatal attachment. The relative importance of potential determinants of maternal antenatal attachment was assessed by the relative contribution of each factor to the fit (R2) calculated from multivariable regression models. Results The sample consisted of 1328 women. Low antenatal attachment (Total MAAS ≤ 75) was observed for 513 (38.6%) women. Perceived social support (having someone to talk to and having access to practical help when needed) emerged as the most important determinant. Furthermore, scores on the MAAS decreased with worse self-rated health, poor physical fitness, depression, increasing age, having given birth previously, and higher education. Conclusion Pregnant women reporting lack of social support and general low physical and mental well-being early in pregnancy may be at risk for developing a poor MAA. An approach targeting both psychosocial and physiological well-being may positively influence expectant mothers’ successful adaptation to motherhood.
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Affiliation(s)
- Ruth K Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Christine W Bang
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Margit Kriegbaum
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette S Væver
- Departmant of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Philip Wilson
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Melissa C Lutterodt
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Adverse Childhood Experiences and Complex Post-traumatic Stress in Pregnant Teens: A Pilot Study. Matern Child Health J 2021; 25:741-750. [PMID: 33389455 DOI: 10.1007/s10995-020-03041-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Pregnant teens are seen as a group at risk, yet one area that remains understudied is the impact of trauma on their mental health, maternal fetal attachment and pregnancy-related health behavior. METHODS A pilot study of urban pregnant teens receiving home visiting services examined trauma exposure, complex traumatic stress, maternal fetal attachment, and health behaviors of pregnancy. The sample (n = 36) was recruited over a period of 20 months from Nurse-Family Partnership of New York City (NFP-NYC) service sites. The teens interviewed completed scales measuring adverse childhood experiences (ACEs), symptoms of complex posttraumatic stress (TSCC), prenatal attachment (MAAS), and pregnancy health behaviors (HPQ-II). FINDINGS Over one third of participants reported 4 or more ACEs (36%), and scores on the Trauma Symptom Checklist subscales ranged from a low of 11% for anger to 25% for depression, anxiety and post-traumatic stress. Maternal-fetal attachment was strong and pregnancy health behaviors were positive. The number of ACEs was related to traumatic stress symptoms but not to maternal fetal attachment or health behaviors in pregnancy. CONCLUSIONS Pregnant teens with trauma histories could benefit from access to trauma-informed mental health services integrated into the obstetrical or home-visiting services they receive.
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Tichelman E, Westerneng M, Witteveen AB, van Baar AL, van der Horst HE, de Jonge A, Berger MY, Schellevis FG, Burger H, Peters LL. Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review. PLoS One 2019; 14:e0222998. [PMID: 31550274 PMCID: PMC6759162 DOI: 10.1371/journal.pone.0222998] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/11/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mother-to-infant bonding is defined as the emotional tie experienced by a mother towards her child, which is considered to be important for the socio-emotional development of the child. Numerous studies on the correlates of both prenatal and postnatal mother-to-infant bonding quality have been published over the last decades. An up-to-date systematic review of these correlates is lacking, however. OBJECTIVE To systematically review correlates of prenatal and postnatal mother-to-infant bonding quality in the general population, in order to enable targeted interventions. METHODS MEDLINE, Embase, CINAHL, and PsychINFO were searched through May 2018. Reference checks were performed. Case-control, cross-sectional or longitudinal cohort studies written in English, German, Swedish, Spanish, Norwegian, French or Dutch defining mother-to-infant bonding quality as stipulated in the protocol (PROSPERO CRD42016040183) were included. Two investigators independently reviewed abstracts, full-text articles and extracted data. Methodological quality was assessed using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional studies and was rated accordingly as poor, fair or good. Clinical and methodological heterogeneity were examined. MAIN RESULTS 131 studies were included. Quality was fair for 20 studies, and poor for 111 studies. Among 123 correlates identified, 3 were consistently associated with mother-to-infant bonding quality: 1) duration of gestation at assessment was positively associated with prenatal bonding quality, 2) depressive symptoms were negatively associated with postnatal mother-to-infant bonding quality, and 3) mother-to-infant bonding quality earlier in pregnancy or postpartum was positively associated with mother-to-infant bonding quality later in time. CONCLUSION Our review suggests that professionals involved in maternal health care should consider monitoring mother-to-infant bonding already during pregnancy. Future research should evaluate whether interventions aimed at depressive symptoms help to promote mother-to-infant bonding quality. More high-quality research on correlates for which inconsistent results were found is needed.
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Affiliation(s)
- Elke Tichelman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- University of Groningen, University Medical Centre Groningen, Department of General Practice & Elderly Care Medicine, Groningen, the Netherlands
| | - Myrte Westerneng
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Anke B. Witteveen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | | | - Henriëtte E. van der Horst
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ank de Jonge
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Marjolein Y. Berger
- University of Groningen, University Medical Centre Groningen, Department of General Practice & Elderly Care Medicine, Groningen, the Netherlands
| | - François G. Schellevis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Huibert Burger
- University of Groningen, University Medical Centre Groningen, Department of General Practice & Elderly Care Medicine, Groningen, the Netherlands
| | - Lilian L. Peters
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- University of Groningen, University Medical Centre Groningen, Department of General Practice & Elderly Care Medicine, Groningen, the Netherlands
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Güney E, Uçar T. Effect of the fetal movement count on maternal-fetal attachment. Jpn J Nurs Sci 2018; 16:71-79. [PMID: 29774647 DOI: 10.1111/jjns.12214] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/10/2018] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to determine the effect of fetal movement counting on maternal-fetal attachment. METHODS This study was a randomized controlled trial, conducted with experimental and control groups, each including 55 pregnant women from six family health centers in the Malatya Province, located in the east of Turkey. The data were collected by using a Personal Information Form and the Maternal Antenatal Attachment Scale. Training for fetal movement counting was provided to the experimental group. The pre- and posttraining maternal-fetal attachment levels of the experimental group (fetal movements that were regularly counted for 4 weeks) and the control group (continual routine monitoring) were compared. RESULTS In the pretraining pretest, no difference was found between the maternal-fetal attachment scores of the experimental and the control groups, whereas the maternal-fetal attachment score of the experimental group was found to be higher than that of the control group in the post-test that was applied 4 weeks later. CONCLUSION This research indicated that fetal movement counting positively affected maternal-fetal attachment.
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Affiliation(s)
- Esra Güney
- Department of Midwifery, İnönü University, Malatya, Turkey
| | - Tuba Uçar
- Department of Midwifery, İnönü University, Malatya, Turkey
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Rubertsson C, Pallant JF, Sydsjö G, Haines HM, Hildingsson I. Maternal depressive symptoms have a negative impact on prenatal attachment – findings from a Swedish community sample. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.992009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Warfa N, Harper M, Nicolais G, Bhui K. Adult attachment style as a risk factor for maternal postnatal depression: a systematic review. BMC Psychol 2014; 2:56. [PMID: 25926974 PMCID: PMC4407393 DOI: 10.1186/s40359-014-0056-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 12/10/2014] [Indexed: 11/25/2022] Open
Abstract
Background Postnatal depression (PND) is an important health problem of global relevance for maternal health and impacts on the health and wellbeing of the child over the life-course. Multinational data is hard to locate, the economic burden of PND on health care systems have been calculated in several countries, including Canada and in the UK. In Canada, health and social care costs for a mother with PND were found to be just over twice that of mothers with no mental illness. The extra community care cost for women with PND living in the UK was found to be £35.7 million per year. Method We carried out a systematic search to the literature to investigate the associations between attachment style and PND, using meta-narrative analysis methods, reporting statistical data and life narratives. The following databases were searched: PsycInfo, PsycExtra Web of Science, The Cochrane Library and Pubmed. We focused on research papers that examined adult attachment styles and PND, and published between 1991 and 2013. We included any papers showing relationship between maternal adult attachment and PND. Out of 353 papers, 20 met the study inclusion criteria, representing a total of 2306 participants. Data from these 20 studies was extracted by means of a data extraction table. Results We found that attachment and PND share a common aetiology and that ‘insecure adult attachment style’ is an additional risk factor for PND. Of the insecure adult attachment styles, anxious styles were found to be associated with PND symptoms more frequently than avoidant or dismissing styles of attachment. Conclusion More comprehensive longitudinal research would be crucial to examine possible cause-effect associations between adult attachment style (as an intergenerational construct and risk factor) and PND (as an important maternal mental health), with new screening and interventions being essential for alleviating the suffering and consequences of PND. If more is understood about the risk profile of a new or prospective mother, more can be done to prevent the illness trajectory (PND); as well as making existing screening measures and treatment options more widely available. Electronic supplementary material The online version of this article (doi:10.1186/s40359-014-0056-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nasir Warfa
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Old Anatomy Building, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ UK ; Faculty Member, HPRT, Department of Continuing Medical Education, Harvard Medical School, 22 Putnam Avenue, Cambridge, MA, Boston 02139 USA
| | - Melissa Harper
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Old Anatomy Building, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ UK
| | | | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Old Anatomy Building, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ UK
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Maternal adjustment and maternal attitudes in adolescent and adult pregnant women. J Pediatr Adolesc Gynecol 2014; 27:194-201. [PMID: 24656707 DOI: 10.1016/j.jpag.2013.09.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. DESIGN, SETTING, AND PARTICIPANTS A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. MAIN OUTCOME MEASURES Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. CONCLUSION Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.
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