Factors affecting the maternal-foetal relationship

Maternal-antenatal attachment is higher in young pregnant women with more social support, mentors, and lower fear of childbirth

The goal of this study was to examine correlates of maternal-fetal attachment in a diverse sample of young pregnant mothers. Although studies have looked at social determinants of health and maternal-fetal attachment, none have examined correlates that may be more prevalent in younger populations including prenatal drug use or fear of childbirth. We analyzed data from a prospective cohort of 154 pregnant adolescents and young adults (75.5% Black/African American, 15.6% white, 7.5% biracial, 1.4% other) ranging from 14-21 years old. Participants were recruited early in pregnancy and completed online surveys during each trimester of pregnancy. Maternal fetal attachment was measured with the Maternal Antenatal Attachment Scale (MAAS) between 30-36 weeks gestation. A linear regression model was constructed to determine the independent contributions of demographic variables (age, race, sexual minority status), maternal mental health, substance use, and social support to maternal-fetal attachment. Third trimester social support, presence of a natural mentor, not having a younger partner, and lower fear of childbirth were associated with higher MAAS scores, and therefore greater maternal fetal attachment, accounting for 32% of the variance in MAAS scores. Maternal age, substance use, and psychological symptoms were not significantly related to maternal fetal attachment in this sample. Social support and patient education to lessen fear of childbirth should be the target of interventions to improve maternal-fetal attachment in adolescent and young adult women. Fostering and supporting mentorship may also be a promising avenue to improve maternal-fetal bonding in younger patients. More research is needed to better understand the impact of perceived health, body dissatisfaction, physical fitness, healthcare access, pre-existing OB/GYN conditions, fear of breastfeeding, history of emotional neglect, and future child rearing support to address gaps in knowledge within this field.

Explaining maternal antenatal attachment by psychological, clinical and sociodemographic factors: a path analysis study

BACKGROUND

Antenatal attachment is a fundamental concept relative to human transition to parenthood and may be influenced by several factors. The aim of this study is to find the best model to explain maternal antenatal attachment based on the interaction among sociodemographic, clinical, and psychological variables.

METHODS

Pregnant women (N = 407) were interviewed during the second trimester of pregnancy while waiting for medical consultations. A sociodemographic, obstetric, and psychometric protocol was used.

STATISTICAL ANALYSES

path analysis.

INDEPENDENT VARIABLES

psychopathological symptomatology, depression, anxiety, stress, occupational stress, attitudes about pregnancy and motherhood, coping styles, marital satisfaction, sociodemographic, and clinical variables.

DEPENDENT VARIABLES

maternal antenatal attachment in its several dimensions; quality of attachment (QA), intensity of preoccupation (IP), and global attachment (GA).

RESULTS

Depression, anxiety, attitudes, and marital satisfaction explained 37% of maternal antenatal QA. Age, depression, anxiety, attitudes, and marital satisfaction explained 26% of maternal antenatal IP. Age, depression, anxiety, attitudes, and marital satisfaction explained 34% of the statistical variance of maternal antenatal GA.

CONCLUSIONS

Factors like emotional states (depression and anxiety), attitudes towards pregnancy and motherhood, marital satisfaction, and a sociodemographic variable (age) contribute significantly for the explanation of maternal antenatal attachment.

The effect of fathers' birth attendance on paternal attachment and the perception of parental role: a randomised controlled trial

BACKGROUND

Fathers' birth attendance is associated with support for mothers in infant care, positive child health outcomes, and parental well-being.

OBJECTIVE

This study was conducted in a randomised controlled experimental design to investigate the effect of fathers' birth attendance on paternal-infant attachment and the perception of parental role.

METHODOLOGY

Pregnant women during the childbirth process and their husbands were included in the study and were randomised according to fathers' birth attendance. The data were collected with the Information Form (IF), Paternal Antenatal Attachment Questionnaire (PAAQ), Self-Perception of Parental Role Scale (SPPRS), Postnatal Paternal-Infant Attachment Questionnaire (PPAQ), and Edinburgh Postnatal Depression Scale (EPDS). The IF data were obtained from women before birth, and the EPDS data were obtained from women 15 days after birth.

RESULTS

Individual characteristics of mothers and fathers in the groups, and prenatal PAAQ and SPPRS scores of the fathers were similar (p > 0.05). In the postnatal period, a significant difference was found in favour of the intervention group in the PPAQ total (p < 0.01), Patience and Tolerance (p < 0.05) and Pleasure in Interaction (p < 0.01) sub-dimensions. The within-group variation of the SPPRS scores of fathers in the intervention and control groups was analysed. The postnatal Competence (p < 0.01) and Integration (p < 0.05) sub-dimension scores statistically significantly increased in both the intervention and control groups compared to the antenatal period.

CONCLUSION

While husbands' accompanying their wives in the delivery room positively affects paternal-infant attachment, its effect on the perception of parental role is an issue that needs to be further investigated.

Manifest anxiety and maternal-fetal attachment in pregnant women with previous fetal losses

AIM

To explore associations between manifest anxiety (Taylor's Manifest Anxiety Scale, TMAS), major obstetric and demographic features and maternal-fetal attachment (MFA) (Maternal Antenatal Attachment Scale, MAAS) in women with previous miscarriages.

SUBJECTS AND METHODS

One hundred pregnant women with previous miscarriages, having uncomplicated singleton pregnancy, not receiving any medications, and conceived in a natural manner . Ages ranged between 19 and 47 years, gestational age between 4 and 35 weeks. Hierarchical multiple linear regression, Kruskal-Wallis test, and ANCOVA were used in data analysis.

RESULTS

Maternal age, gestational age, previous abortions, parity, maternal education, and marital status in combination contributed significantly to the regression model in prediction of the MAAS quality and intensity scores. Adding the TMAS score accounted for an additional 17% of variation in the MAAS quality score, and the change in R2 was significant. There was a negative relationship between the TMAS and the MAAS quality scores. The TMAS score did not contribute to prediction of the MAAS intensity. The highest TMAS values were in the women having anxious, ambivalent or affectless preoccupation.

CONCLUSION

Prevention of negative consequences of poor quality of MFA in women with previous miscarriages should include early screening for manifest anxiety.

The relationship between maternal-fetus attachment and perceived parental bonds in pregnant women: Considering a possible mediating role of psychological distress

Maternal-Fetal Attachment (MFA) delineates the emotional, cognitive, and behavioral aspects that mothers develop toward the unborn baby during pregnancy. The literature indicates that optimal attachment in pregnancy represents a protective factor for the mother-child attachment bond after birth and child development outcomes. To date, there are few studies that have investigated associated factors of MFA. This study sets out to explore the association between perceived parental bonds and maternal-fetal bonding in pregnant women, accounting for factors such as psychological distress, socio-demographic and obstetric characteristics.

Methods

In this cross-sectional study, 1,177 pregnant women answered the Parental Bonding Instrument, the Maternal-Fetal Attachment Scale, State-Trait Anxiety Inventory (STAI-Y), and Beck-Depression Inventory (BDI-II).

Results

We found out that perceived maternal and paternal care had significant direct effects on maternal-infant bonding during the pregnancy period when controlling for some confounders, including gestational age and mother age among others. Such maternal and paternal perceived care effects were not mediated by levels of psychological distress, which in turn resulted to be a "borderline" significant predictor of prenatal attachment. Interestingly, the gestational age and the mother age emerged to have a significant and synergic nonlinear effect, suggesting the influence on the MFAS of the gestational age depends on the values of the mother age, and likewise, the effect of mother age on MFAS depends on the gestational week.

Conclusion

This study expands our knowledge of the intergenerational transmission of attachment pointing out the effects of a woman's perceived bond in relation to her parental figures during the development of the prenatal attachment process. Findings also suggests that parenting support interventions may have benefits that are realized across generations.

The mediating role of prenatal depression in adult attachment and maternal-fetal attachment in primigravida in the third trimester

BACKGROUND

Prenatal depression and adult attachment are factors that affect the establishment of an intimate relationship between a mother and fetus. The study explored differences in prenatal depression and maternal-fetal attachment (MFA) scores between different types of adult attachment and the effects of maternal depression scores and attachment dimensions on maternal intimacy with the fetus.

METHODS

The Edinburgh Postnatal Depression Scale (EPDS), Experience of Close Relationship (ECR) scale, Maternal Antenatal Attachment Scale (MAAS) and a general data scale were used to investigate 260 primigravida. An exploratory analysis was performed to analyze the effects of the depression score and adult attachment on MFA.

RESULTS

The results showed that pregnant women with insecure attachment exhibited an increased prevalence of prenatal depression, lower total MFA scores, and lower MFA quality compared with those women with secure adult attachment. The explorative analysis showed that the depression scores mediated the relationship between adult attachment avoidance and MFA quality.

CONCLUSIONS

Primigravida who had insecure adult attachment exhibited an increased prevalence of prenatal depression and lower MFA. Maternal depression and adult attachment may affect the emotional bond between a mother and fetus. This finding should be seriously considered, and timely intervention needs to take personality traits into consideration.

Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment

Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment.

Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment.

Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality.

Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.