Abstract
Pregnancy offers a unique period for initiating preventive parenting interventions. Disturbances in maternal-fetal bonding may indicate suboptimal parenting and a need for intervention. However, more knowledge is needed on the development of maternal-fetal bonding among at-risk groups. The study aim was to examine psychosocial correlates of maternal-fetal bonding among pregnant women identified to be at risk socially and regarding their mental health. The sample consisted of 78 at-risk pregnant women participating in a perinatal intervention study: Godt på Vej Sammen [A Good Start to Life-an Early Cross-sectorial Intervention]. This study was cross-sectional reporting on the baseline characteristics of the participants. In the beginning of the second trimester, participants completed questionnaires assessing maternal-fetal bonding (the Maternal Antenatal Attachment Scale [MAAS]), prenatal parental reflective functioning, adult attachment style, and depressive symptoms. We compared the distribution of MAAS styles with norms from a recent Dutch community sample. In addition, we tested associations between psychosocial variables and the quality and intensity of MAAS scores in regression models and performed Chi-square analyses to assess the association of MAAS styles with psychosocial variables. First, compared to women from a community sample, approximately half of the women in our sample presented lower and suboptimal MAAS scores. Second, insecure avoidant adult attachment style was negatively associated with MAAS intensity, and depressive symptoms were negatively associated with MAAS quality. Third, prenatal parental reflective functioning positively correlated with both quality and intensity of MAAS. Fourth, we found no association between insecure anxious adult attachment style and MAAS scores. Fifth, women with a negative disinterested MAAS style demonstrated the highest avoidant attachment scores, while women with a positively preoccupied MAAS style demonstrated the highest prenatal parental reflective functioning scores. The results suggest that there is a need to differentiate among at-risk pregnant woman and that prenatal screening using the MAAS may help identify those who need preventive parenting interventions and what those interventions should focus on. A main limitation of the study is the lack of a representative group of at-risk pregnant women which limits the generalizability of the study results to all risk groups.
Highlights
A central developmental task of pregnancy is for the future mother to prepare herself psychologically for the challenges of childcare and parenthood by gradually increasing her emotional engagement with the fetus [1]
The results suggest that there is a need to differentiate among at-risk pregnant woman and that prenatal screening using the Maternal Antenatal Attachment Scale (MAAS) may help identify those who need preventive parenting interventions and what those interventions should
It is interesting that we found moderate-to-strong effect sizes for the association between P-parental reflective functioning (PRF) and MAAS, and it is possible that the two constructs measure overlapping psychological phenomena
Summary
A central developmental task of pregnancy is for the future mother to prepare herself psychologically for the challenges of childcare and parenthood by gradually increasing her emotional engagement with the fetus [1]. Women with a history of mental disorders or who experience life stress or negative life events are at particular high risk for antenatal depression [11] Research on MFB involving at-risk groups is sparse, and the few existing comparative studies involving high- and low-risk groups of pregnant women have shown conflicting results [2, 8, 10]. In a recent study of contextual risk factors, such as exposure to poverty and violence, Dayton and colleagues found that more psychological distress, a composite of depressive, anxious, and stress-related symptoms, was associated with lower MFB [15]
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