Fetal Attachment Research Articles

The relationship of maternal–fetal attachment and depression with social support in pregnant women referring to health centers of Tabriz–Iran, 2016

Purpose: The objective of this study was to determine the relationship of maternal–fetal attachment and depression during pregnancy with social support. Methods: This cross-sectional study was done on 287 primipara women. The data collection tools used included a demographic characteristics questionnaire, Maternal–Fetal Attachment Scale, the Edinburgh Postnatal Depression Scale and the Social Support Scale. Pearson’s correlation test and general linear model were used for data analysis. Results: The mean maternal–fetal attachment score was 90.0 (SD: 10.3). The highest score was obtained in the “role taking” domain and the lowest in the “interaction with the fetus” domain. The mean depression score was 8.5 (SD: 4.0). The score of perceived social support was 135.5 (SD: 15.6). Pearson’s correlation test showed a significant positive correlation between social support and maternal–fetal attachment (r = 0.36, p < .001) and a significant negative correlation between social support and depression (r= −0.14, p = .018). Conclusion: The present study found a significant relationship between maternal–fetal attachment, depression and social support. It is recommended to devise plans for increasing the support given to women and to improve the society’s and families’ awareness about these issues in the attempt to have healthy mothers and thereby healthy families and communities.

War trauma and maternal–fetal attachment predicting maternal mental health, infant development, and dyadic interaction in Palestinian families

ABSTRACTOptimal maternal–fetal attachment (MFA) is believed to be beneficial for infant well-being and dyadic interaction, but research is scarce in general and among risk populations. Our study involved dyads living in war conditions and examined how traumatic war trauma associates with MFA and which factors mediate that association. It also modeled the role of MFA in predicting newborn health, infant development, mother–infant interaction, and maternal postpartum mental health. Palestinian women from the Gaza Strip (N = 511) participated during their second trimester (T1), and when their infants were 4 (T2) and 12 (T3) months. Mothers reported MFA (interaction with, attributions to, and fantasies about the fetus), social support, and prenatal mental health (post-traumatic stress disorder, depression, and anxiety) at T1, newborn health at T2, and the postpartum mental health, infant’s sensorimotor and language development, and mother–infant interaction (emotional availability) at T3. Results revealed, first, that war trauma was not directly associated with MFA but that it was mediated through a low level of social support and high level of maternal prenatal mental health problems. Second, intensive MFA predicted optimal mother-reported infant’s sensorimotor and language development and mother–infant emotional availability but not newborn health or maternal postpartum mental health.

Predictors of Maternal Fetal Attachment among Pregnant Women

Predictors of Maternal Fetal Attachment among Pregnant Women

S2-1 Effects of Depression and Fetal Attachment on Bonding at Two Years Postpartum(ISPOG2007)

S2-1 Effects of Depression and Fetal Attachment on Bonding at Two Years Postpartum(ISPOG2007)

Relationship among Emotional Clarity, Maternal Identity, and Fetal Attachment in Pregnant Women with Gestational Diabetes Mellitus.

The purpose of this study was to examine the relationship among emotional clarity in emotional intelligence, maternal identity, and fetal attachment to measure how emotional clarity and maternal identity impact on fetal attachment and to determine mediating effects of maternal identity in pregnant women at the time of diagnosis with gestational diabetes mellitus (GDM). This study used a correlational survey design. 88 pregnant women with GDM completed a study questionnaire of emotional clarity, maternal identity, and fetal attachment immediately after the diagnosis of GDM. Data were analyzed Mann-Whitney U test, and ANOVA with Duncan test, Pearson correlation, three-step regressions to test mediating effect, and Sobel test. The emotional clarity was positively related with maternal identity and fetal attachment. It affected maternal identity with 21.9% of explained variance. The emotional clarity and the maternal identity were significant predictors of fetal attachment by 57.7% of explained variance. The maternal identity mediated the relationship between emotional clarity and fetal attachment. The results suggest that a nursing program to enhance the emotional clarity and the maternal identity needs to be developed as an effective strategy to improve fetal attachment.

Cold-perfusion decellularization of whole-organ porcine pancreas supports human fetal pancreatic cell attachment and expression of endocrine and exocrine markers

Despite progress in the field of decellularization and recellularization, the outcome for pancreas has not been adequate. This might be due to the challenging dual nature of pancreas with both endocrine and exocrine tissues. We aimed to develop a novel and efficient cold-perfusion method for decellularization of porcine pancreas and recellularize acellular scaffolds with human fetal pancreatic stem cells. Decellularization of whole porcine pancreas at 4°C with sodium deoxycholate, Triton X-100 and DNase efficiently removed cellular material, while preserving the extracellular matrix structure. Furthermore, recellularization of acellular pieces with human fetal pancreatic stem cells for 14 days showed attached and proliferating cells. Both endocrine (C-peptide and PDX1) and exocrine (glucagon and α-amylase) markers were expressed in recellularized tissues. Thus, cold-perfusion can successfully decellularize porcine pancreas, which when recellularized with human fetal pancreatic stem cells shows relevant endocrine and exocrine phenotypes. Decellularized pancreas is a promising biomaterial and might translate to clinical relevance for treatment of diabetes.

The Effect of Relaxation on Mother's Anxiety and Maternal–Fetal Attachment in Primiparous IVF Mothers

ObjectivesInfertility is one of the main stressful events of life and a crisis affecting various dimensions of infertile couples' lives. Relaxation, as a strategy, can be effective in the individuals' resistance to stress and anxiety. Therefore, the present study aimed to assess the effect of relaxation on mother's anxiety and maternal–fetal attachment in primiparous women who used In Vitro Fertilization (IVF) to get pregnant. MethodsIn this clinical trial, 80 primiparous women who had used IVF to get pregnant were randomly divided into a control and an intervention group. The intervention group took part in four 90-min relaxation classes in addition to receiving the routine pregnancy care. Anxiety and maternal–fetal attachment were evaluated before and one month after the intervention. Also, maternal–infantile attachment score was computed after delivery. The statistical analyses were performed using the SPSS statistical software. Chi-square and independent t-test was used to analyze the data. ResultsThe results revealed no significant difference between the two groups regarding the mean scores of anxiety and attachment before the intervention. However, a significant difference was observed in this regard after the intervention (41.4 ± 4.1 vs. 51.0 ± 10.4, P < 0.01). ConclusionThe study results showed that relaxation training was effective in reduction of anxiety and increase of maternal–fetal attachment in the women who had used IVF to get pregnant. Although there are other methods for reducing anxiety, relaxing can be used for IVF women due to its ease of use and its wide acceptance.

The Influence of Fathers-to-be’s Attachment Experience to Parents of Origin in Childhood on Their Fetal Attachment: Examining the Mediating Effect of Romantic Attachment

The Influence of Fathers-to-be’s Attachment Experience to Parents of Origin in Childhood on Their Fetal Attachment: Examining the Mediating Effect of Romantic Attachment

Prediction of Maternal-Fetal Attachment Based on the Components of Gender Role in Pregnant women

Background and aim: Maternal concept is part of the feminine gender role. The important part of the maternal concept is the unique relationship experience between mother and child that begins with maternal-fetal attachment(MFA) during pregnancy. The aim of this study is predict the MFA according to Gender role in pregnant women in Shiraz city. Methods:This descriptive correlational study was conducted on 171 primiparous and multiparous women with Gestational age above 24 weeks of pregnancy reffering to the obstetric and midwifery department of Shiraz –Kowsar Hospital during 2 monthes period from May to June 2015, which were selected using the Purposive sampling.Data were collected using a Demographic obstetric questionnaire including age and obstetric information,Cranly’s Maretnal Fetal Attachment questionnaire(validity:0.85) and Bem Gender Role questionnaire(reliability:0.90) were used during this study. For data analysis Pearson correlation coefficient and multiple regression were performed,using spss version 16. Results: Results showed a statistically significant correlation between components of femininity and masculinity of gender role with maternal-fetal attachment. Maximum correlation was between Masculinity and MFA ( R=0.33, P=0.001) and then between Femininity and MFA (R=0.24,P=0.009).There was no correlation between neutral and MFA.(R=0.12,P=0.084) Almost 14% of the variance in maternal-fetal attachment was explained by gender role . According to the comparison of regression coefficients, the femininity indicator (β=0.159 ,P=0.015) and masculinity indicator (β=0.266, P=0.001) were positively predicted the maternal-fetal attachment, but neutral component (β=0.109, P=0.064) was not predicted the maternal-fetal attachment (Table 2). Conclusions: Gender role is part of mental health that predicts MFA during pregnancy. Mental health of mother and fetus can be improved by identifying mothers based Gender role. These finding could be used for promoting maternal fetal attachment behaviors during pregnancy.

Effect of Guided Imagery on Maternal Fetal Attachment in Nulliparous Women with Unplanned Pregnancy

Background & aim: Nulliparous women with unplanned pregnancy experience high levels of anxiety, which may adversely affect maternal-fetal attachment. Therefore, in this study, we aimed to determine the effect of guided imagery on maternal-fetal attachment in nulliparous women with unplanned pregnancy. Methods: In this clinical trial, 67 nulliparous women with unplanned pregnancy were randomly divided into two groups of intervention (n=35) and control (n=32) in 2015. Data collection tools included a demographic form and London, DASS 21, and Cranley's maternal-fetal attachment questionnaires. In the intervention group, one session of guided imagery on maternal role was performed in 34th week of pregnancy in groups of four to seven. Afterwards, guided imagery CDs were given to mothers to be performed at home twice a week for two weeks; the control group only received the routine care. Maternal-fetal attachment was assessed before and two weeks after the intervention. To analyze the data, independent t-test, paired t-test, Chi-squared, Fisher’s exact test, and Mann-Whitney U tests were run using SPSS version 21. Results: Maternal mean age was 24.1±4.3 years, and most mothers (49.3%) had high school education. Mean score of maternal-fetal attachment was significantly different between the intervention (94.26±6.7) and control (90.22 ± 9.5) groups after the intervention (P=0.04). Also, there was a significant difference between mean score of maternal-fetal attachment at the beginning and end of the intervention in the intervention and control groups (5.86±7.2 vs. 1.72±3.2; P=0.004). Conclusion: Guided imagery promoted maternal-fetal attachment in women with unplanned pregnancy; thus, it is recommended to use this method in prenatal care for these women.

Re-Evaluation of the Psychometric Properties of the Maternal–Fetal Attachment Scale in a Hungarian Sample

ObjectiveTo explore the factor structure of the Maternal–Fetal Attachment Scale (MFAS) and investigate its psychosocial and demographic correlates in a Hungarian sample. DesignCross-sectional survey. SettingSonography clinic in a metropolitan area. ParticipantsOne hundred fourteen women over the age of 18 years in the second or third trimesters of pregnancy. MethodsParticipants completed the Hungarian version of the MFAS and provided information on demographic, socioeconomic, and pregnancy-related factors. ResultsThe internal consistency of the MFAS total scale was acceptable (Cronbach's alpha = .87). However, the reliability of the five subscales was low (alpha coefficients between .57 and .74), and the original five-factor model was not supported by the factor analyses. Married mothers had higher scores on the MFAS than participants who were unmarried, and uncertainty about the sex of the fetus was associated with lower attachment scores. Furthermore, gestational age showed a positive correlation with MFAS scores. No significant association was found between the total score on the MFAS and such factors as age, income, or education of the parents; whether the pregnancy was planned; method of conception; number of children born previously; prior perinatal losses; and circumstances of the mother's own birth. ConclusionOur study showed that marital status, uncertainty about the sex of the fetus, and gestational age were associated with maternal–fetal attachment; however, more detailed analysis was not possible because of the instability of the subscales of the instrument. Further research is warranted on the underlying factors related to maternal–fetal attachment.

Correlation of maternal-fetal attachment and health practices during pregnancy with neonatal outcomes.

IntroductionLow birth weight due to preterm delivery or intrauterine growth restriction (IUGR) is the strongest factor contributing to prenatal, neonatal, and postnatal mortality. Maternal–fetal attachment plays a significant role in maternal and fetal health. Health practices performed by the mother during pregnancy constitute one of the factors that may affect neonatal outcomes. The present study was conducted to identify the relationship between maternal–fetal attachment and health practices during pregnancy with neonatal outcomes.MethodsThis cross-sectional study was conducted on 315 pregnant women with a gestational age of 33–41 weeks who presented to hospitals in Sirjan (Iran) between December 2014 and February 2015. The data collection tools used included the Health Practices in Pregnancy Questionnaire and the Maternal Fetal Attachment Scale. Data were analyzed using IBM-SPSS version 20, focusing on the Pearson product–moment correlation and the logistic regression model. Statistical significance was set to p<0.05.ResultsThe mean score of maternal–fetal attachment was 60.34, and the mean score of health practices was 123.57. The mean birth weight of the neonates was 3052.38 g. Health practices (p<0.05, r=0.11) and maternal-fetal attachment (p<0.01, r=0.23) were positively and significantly correlated with neonatal outcomes. A significant positive relationship was also observed between maternal–fetal attachment and neonatal outcomes. No significant relationships were observed between health practices during pregnancy and neonatal outcomes.ConclusionMaternal-fetal attachment and health practices during pregnancy are positively and significantly correlated with neonatal outcomes.

In-hospital Breastfeeding and Intention to Return to Work Influence Mothers' Breastfeeding Intentions.

Research continues to demonstrate that formula feeding is associated with numerous long-term negative outcomes for a mother and her infant. However, many women cease breastfeeding sooner than intended and recommended. Breastfeeding has been found to be related to demographics, maternal mood, and returning to work outside the home. This study aimed to shed light on the woman's perception of the effect of working on intended breastfeeding duration. This study used intentions to return to work and in-hospital breastfeeding to predict breastfeeding intentions. Women (N = 160) were surveyed during the first 48 hours postdelivery of healthy, full-term infants. Survey instruments included demographics (socioeconomic status, maternal age, education, and marital status), depression, fetal attachment, current exclusive breastfeeding status, as well as breastfeeding and return-to-work intentions for the next year. A path analysis was used to explore relationships and predictors of breastfeeding intentions. The model had a good fit and breastfeeding intentions were predicted by exclusive breastfeeding in the hospital (β = 0.21, P < .01) and negatively predicted by return to work (β = -0.18, P < .05). Exclusive breastfeeding in the hospital within the first 48 hours postpartum and intention to return to work influence how long a mother intends to breastfeed. Attention to these areas can be provided immediately postpartum to support exclusive breastfeeding and provide informational support on continuing to breastfeed/express milk upon return to work if the mother intends to return to work.

The Hungarian adaptation and potential use of the Maternal-Fetal Attachment Scale questionnaire measuring mother-to-fetus attachment during ultrasound communication examinations

Research measuring the effectiveness of communication during ultrasound examinations draw attention to its use in strengthening the bond between mother and fetus. Hungarian adaptation of the Maternal-Fetal Attachment Scale, which is the most commonly used tool for measuring intrauterine attachment. 114 pregnant women in the second or third trimester filled out the Hungarian version of the Maternal-Fetal Attachment Scale and an application form. The questionnaire showed excellent internal consistency, with a Cronbach's alpha of 0.87 for the total score. Married women scored significantly higher and scores increased as pregnancy progressed. Uncertainty surrounding the fetus's gender influenced attachment in the negative direction. There was no significant relationship between attachment total scores and a number of psycho-social factors. In the family-centered prenatal care the Maternal-Fetal Attachment Scale is a suitable tool to analyze ultrasound screening situations that strengthen the bond between mother and fetus.

Effect of Therapeutic Massage on Relieving Pregnancy Discomforts

The Physical and physiological changes occurring during pregnancy associated with negative symptoms which have been shown to impact on the wellbeing of the mother and fetus. Massage therapy was expected to have a positive impact on pregnant women by decreasing stress hormones and potential stressors such as anxiety, leg, back pain and improve mood, sleep and fetal attachment. Aim of the study: To study the effect of therapeutic massage on relieving pregnancy discomforts. Design: An intervention study design was utilized for the study. Setting: this study was conducted at maternal and child health centers for antenatal care at Shebin Elkoom. Sample: A total of 150 pregnant women were recruited in the study. Tools: Four tools were developed and used; 1) A structured interviewing questionnaire, 2) Subjective pain scale (visual-analogue scale (VAS)); 3) sleep scale and 4) anxiety scale. Results: There were statistically significant differences between the two groups regarding pregnancy discomforts as headache, backache, muscle cramp, sleep disturbance and anxiety (p=.000), while there was not statistically significant difference related to joint pain (p=0.53). Women reported that therapeutic massage was very effective on relieving pregnancy discomforts with highly statistically significant differences. Conclusion and recommendations: Therapeutic massage was effective method for reducing discomforts related pain and can be clinically recommended as an alternative, safe and affordable method of pain relief during pregnancy. So it is recommended to raise nurses' awareness regarding use of massage therapies for pregnant women as antenatal routine care. Further studies were needed to apply other non-pharmacological relieving measures for pregnancy discomforts.

Influence of Social Support and Self-Esteem on Maternal-Fetal Attachment in Unmarried Pregnant Women

The present study aimed to identify factors affecting maternal–fetal attachment behaviors among unmarried pregnant women. The research participants included 105 unmarried pregnant women from 15 shelters for unmarried mothers around the country. The data were collected from January to February 2015 through a survey and descriptive statistics, t-tests, ANOVAs, Pearson correlations, and hierarchical regression analysis were analyzed using SPSS 20. The results suggest that current childcare plans and support from friends were significant factors affecting maternal–fetal attachment behaviors. The overall explanatory power of these variables for maternal–fetal attachment behaviors was 30.5%, with friend support being more influential than current childcare plans. This study indicates that prenatal care aimed at enhancing the maternal– fetal attachment of unmarried pregnant women would benefit from taking childcare plans and support from friends into consideration.

Predictive Importance of Antenatal Depressive Rumination and Worrying for Maternal–Foetal Attachment and Maternal Well-Being

Rumination and worrying are relevant to the onset and maintenance of depression and anxiety. Yet, it is unclear, whether depressive rumination and worrying are predictive for depressive and anxious symptomatology during pregnancy. Likewise, the potential role of depressive rumination and worrying for maternal–foetal attachment has been rarely explored. In the present longitudinal study, N = 215 pregnant women were assessed within the first 4 months of pregnancy and again in the last 4 months of pregnancy. Using regression analysis, associations between worrying and depressive rumination on the one hand and maternal–foetal attachment, depression and anxiety on the other were studied—controlling for age, number of children, social support and baseline antenatal depressive and anxious symptoms. Baseline rumination was a significant predictor of impairments in maternal–foetal attachment in later pregnancy. Baseline worrying was a significant predictor of heightened depressive symptoms and anxiety. These effects were of modest magnitude. Nonetheless, our findings reveal that different types of perseverative thinking (i.e., rumination vs. worry) might have differential effects on maternal well-being and maternal–foetal attachment.

Psychometric properties of a 20-item version of the Maternal–Fetal Attachment Scale in a sample of Italian expectant women

Objectivethe Maternal–Fetal Attachment Scale (MFAS), a 24-item self-report questionnaire to measure the antenatal maternal feeling towards the unborn baby, was introduced by Mecca Cranley in 1981. Despite the widespread use of the questionnaire in clinical and research contexts, issues exist about its psychometric properties. An analysis of the literature showed the need for studies aimed at reviewing the MFAS by eliminating some items and modifying and "modernising" others. This study started from these suggestions and aimed to investigate the psychometric properties of a modified 20-item Italian version of the scale. Designthe original MFAS was back translated and then administered to a pilot sample of 20 pregnant women in order to identify items hard to understand, inappropriate or ambiguous. On the basis of qualitative information derived from this pilot phase, we developed a 20-item Italian version of the MFAS that was later administered to a large sample of pregnant women. Settingantenatal education classes carried out in public and private structures of Italian central and insular regions. Participantsa sample of 482 women in middle and late pregnancy, attending antenatal education classes between February 2013 and October 2014. Measurementsthe modified MFAS was administered together with other scales measuring maternal–fetal attachment, psychological well-being, relational variables. Internal consistencies were evaluated using Cronbach׳s alpha. Nomological validity was assessed via Pearson correlations. Exploratory and confirmatory factor analyses were used to test the factor structure. Findingsthe hypothesised relationships with external criteria were partially substantiated. Exploratory factor analyses suggested a three-dimensional structure. Confirmatory factor analyses provided general support for an oblique three-factor model. Internal consistency was adequate for the total scale and for two of the three subscales. Key conclusion and implications for practicethe 20-item Italian version of the MFAS is a reliable measure of maternal attachment to the fetus in Italian women. Cranley׳s five dimensions were not confirmed; instead, three factors emerged that could be renamed ׳Future parental roletaking׳, ׳Present interaction with the baby׳ and ׳Giving of self and responsibility to the unborn child׳. As maternal–fetal attachment is considered a predictor of the quality of the postnatal mother–child relationship, the MFAS could be a helpful tool in pre- and perinatal research and midwifery care to develop prevention programs based on women specific needs. Moreover, the availability of this questionnaire can assist in expanding research and in facilitating trans cultural comparison in issues related to pregnancy.

The Influence of Anxiety and Dyadic Adjustment on Maternal–Fetal Attachment in High-Risk Pregnant Women

Purpose: This study attempted using a descriptive survey to elucidate the influence of anxiety and dyadic adjustment on maternal–fetal attachment in high-risk pregnant women. Methods: The data used in this study were collected from March 3 rd , 2015, to March 30 th , 2015, and the participants were 118 pregnant women including those undergoing prenatal tests and those admitted to a delivery room in the obstetrics outpatient center of 3 university hospitals located in B, D, and Y after diagnosis with high-risk pregnancy during 20–38 weeks of gestation. Collected data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson’s correlation, and stepwise regression analysis using the IBM SPSS 22.0 program. Results: The level of maternal–fetal attachment according to participants’ general and obstetric characteristics showed significant differences in history of childbirth, prenatal tests, and planned pregnancy. The factors that influenced maternal–fetal attachment were history of childbirth, prenatal tests, anxiety, and dyadic adjustment. Lower anxiety and high dyadic adjustment of high-risk pregnant women led to a high maternal–fetal attachment. Among them, anxiety was the factor with the greatest impact, explaining 20.5%. Conclusion: This study presents the need for development and application of prenatal nursing intervention to enhance maternal–fetal attachment by lowering anxiety through prenatal care in high-risk pregnant women and improving dyadic adjustment.

Medical Technology and Related Interventions on Maternal-Fetal Attachment: A Literature Review

In this review of recent research on the effects of interventions on maternal–fetal attachment. There are limited data from several countries to demonstrate the impact of medical technology and intervention programs on maternal-fetal attachment.