Abstract
BackgroundDevelopment 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.MethodsA 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.ResultsThe 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.ConclusionPregnant 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.
Highlights
Development of the maternal antenatal attachment (MAA) constitutes an important aspect of the transition into motherhood
In 1981 MAA was defined by Cranley as “the extent to which women engage in behaviours that represent an affiliation and interaction with their unborn child” [7]; it is characterised by cognitions, feelings and behaviours towards the fetus [8], and intensifies as pregnancy progresses [9]
We investigate the relative contribution of an extensive set of first trimester factors either found in the woman’s pregnancy record or which are examined during a first pregnancy consultation to the strength of MAA measured in the third trimester using the Maternal Antenatal Attachment Scale (MAAS) [4]
Summary
Development of the maternal antenatal attachment (MAA) constitutes an important aspect of the transition into motherhood. The pregnant woman’s successful adaptation to motherhood is closely linked with the development of an emotional bond with the fetus, that is, the mental representation of the fetus and feelings of being connected. While authors have used several terms to capture this phenomenon, for example, ‘antenatal attachment’ [4], ‘maternal–fetal attachment’ [5], and ‘prenatal attachment’[6], in the present paper, following Condon (1993), we use the term maternal antenatal attachment (MAA). Stressing the representational aspects of the phenomenon, Condon (1993) described MAA as the emotional bond that the pregnant woman develops with the fetus [4]. While the quality of attachment is usually described as secure/insecure (e.g. [10, 11], MAA is typically described in terms of high/low ‘intensity’, reflecting strength of the relationship, and high/low ‘quality’ (reflecting positive/negative feelings towards the fetus (e.g. [12])
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