Which social, gestational and mental health aspects are associated to maternal-fetal attachment?

Rubin, Bárbara Borges; Matos, Mariana Bonati de; Trettim, Jéssica Puchalski; Scholl, Carolina Coelho; Cunha, Gabriela Kurz da; Curcio, Eduarda; Stigger, Rafaelle Stark; Martins, Clarissa de Souza Ribeiro; Motta, Janaína Vieira dos Santos; Ghisleni, Gabriele; Pinheiro, Ricardo Tavares; Quevedo, Luciana de Avila

doi:10.1590/1806-9304202300000361-en

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 23 • 2023 • https://doi.org/10.1590/1806-9304202300000361-en linkcopy

Which social, gestational and mental health aspects are associated to maternal-fetal attachment?

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women.

Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors.

Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]).

Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Key words:
Maternal-fetal attachment; Prenatal bonding; Social support; Maternal health; Pregnancy

Variables	N	%	Maternal-Fetal Attachment	p
Variables	N	%	x ± SD	p
Economic class*				0.113
Higher classes (A+B)	216	26.2	97.6 ± 11.3
Middle class (C)	473	57.5	99.3 ± 11.4
Lower classes (D+E)	134	16.3	97,7 ± 12,6
Schooling (years of study)				0.869
Up to 3	14	1.7	100.8 ± 10.5
4-7	161	19.2	98.4 ± 12.0
8-10	190	22.6	98.2 ± 12.1
11 years or more	475	56.5	98.7 ± 11.2
Age (years)				0.357
Up to 23	268	31.9	99.3 ± 11.4
24-29	272	32.4	97.9 ± 12.1
Above 30	300	35.7	98.5 ± 11.5
Lives with a partner				<0.001
No	170	20.2	95.2 ± 12.2
Yes	670	79.8	99.4 ± 11.2
Trimester of pregnancy				<0.001
First and second trimester	261	31.1	96.0 ± 10.7
Third trimester	579	68.9	99.7 ± 12.9
Previous pregnancy				0.160
No	357	42.5	99.2 ± 11.3
Yes	483	57.5	98.1 ± 11.7
Planned pregnancy				0.032
No	374	44.5	97.6 ± 12.2
Yes	466	55.5	99.3 ± 10.9
Mother’s support				0.030
No	120	14.3	96.2 ± 13.2
Yes	720	85.7	99.0 ± 11.2
Child’s father support				0.042
No	39	4.6
Yes	801	95.4	98.7 ± 11.4
Tobacco abuse/dependence				0.982
No	704	83.8	98.6 ± 11.5
Yes	136	16.2	98.5 ± 11.9
Alcohol abuse/dependence				0.019
No	761	90.6	98.9 ± 11.5
Yes	79	9.4	95.7 ± 11.3
Depressive symptoms*				<0.001
No	712	84.9	99.5 ± 10.8
Yes	127	15.1	93.4 ± 14.2
Anxiety symptoms*				0.013
No	560	66.7	99.3 ± 11.3
Yes	279	33.3	97.2 ± 12.0
Total	840	100.0	98.6 ± 11.6	-

Variables	Maternal-Fetal Attachment
Variables	B	CI95%	p	t	VIF	R²
Level 1						0.000
Economic class (higher classes A+B*)	1.0	-0.2; 2.2	0.114	1.583	1.070
Level 2						0.064
Lives with a partner (yes*)	-3.9	-6.0; -1.7	<0.001	-3.552	1.245
Trimester of pregnancy (third trimester*)	-4.3	-6.0; -2.6	<0.001	-5.059	1.025
Previous pregnancy (no*)	-0.5	-2.1; 1.1	0.561	-0.582	1.067
Planned pregnancy (yes*)	-1.1	-2.7; 0.5	0.178	-1.349	1.060
Mother’s support (yes*)	-2.4	-4.6; -0.2	0.035	-2.117	1.052
Child’s father support (yes*)	-0.8	-4.7; 3.1	0.692	-0.396	1.181
Level 3						0.090
Alcohol abuse/dependence (no*)	-2.2	-4.9; 0.4	0.101	-1.641	1.022
Depressive symptoms (no*)	-5.0	-7.4; -2.5	<0.001	-3.987	1.318
Anxiety symptoms (no*)	-0.0	-1.8; 1.8	0.995	-0.006	1.288

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[TFN1] ^*
Variables with missing; SD = standard deviation.