Maternal Antenatal Attachment Scale Research Articles

Maternal-fetal attachment among pregnant women at risk for mental health: A Comparative Study

<b>Aim:</b> In this study, it was aimed to determine maternal-fetal attachment among pregnant women at risk for mental health.<br /> <b>Methods:</b> This cross-sectional study was conducted with 404 women between June 10, 2023 and August 1, 2023. Data were collected with the Personal Information Form, the Maternal Antenatal Attachment Scale (MAAS), and the General Health Questionnaire (GHQ-28). The data were evaluated according to the General Health Questionnaire (GHQ-28) mean score, by dividing them into two groups as those at risk for mental health and those without risk for mental health.<br /> <b>Results:</b> The MAAS mean score of the women participating in the study was 67.78±9.66, and the mean scores of the subscales of "Attachment Quality" and "Time Spent on Attachment" of the MAAS were 40.82±55.33 and 26.95±5.62, respectively; it was determined that the mean score they got from the GHQ-28 was 2.98±3.81. Between the groups with high-risk and non-risky pregnancies, the mean scores of the MAAS and the subscale of Attachment Quality were found to be higher in non-risky pregnancies (p<0.05). Additionally, it was determined that the mean score of “Time Spent on Attachment” of non-risky pregnant women was higher than that of high-risk pregnant women, but there was no statistically significant difference between the groups (p> 0.05). The GHQ-28 mean score was lower in non-risky pregnant women (p<0.05).<br /> <b>Conclusion</b>: In the study, it was determined that the maternal-fetal attachment levels of pregnant women with psychological risk were low. Therefore, the results suggest that it is necessary to determine mental problems in pregnant women and to conduct screening programs more frequently.

Relationship between maternal antenatal attachment and traumatic childbirth perception among pregnant women.

To examine the relationship between the perception of traumatic birth and maternal attachment in pregnant women. This descriptive and correlational study recruited 370 pregnant women who applied for an antenatal visit to outpatient clinics of a state hospital. The data were collected using a Personal Information Form, Maternal Antenatal Attachment Scale (MAAS), and Traumatic Birth Perception Scale (TBPS). Data were collected using the face-to-face method. The study was reported according to the STROBE. The mean total score of MAAS was 75.71 ± 7.72 and the mean TBPS score was 73.21 ± 28.34. Normal birth pain was perceived as "severe" by 38.3% of pregnant women and as "very severe" by 46.1%. It was determined that 29.2% of pregnant women had a "high" level of traumatic birth perception and 14.5% had a "very high" level. A negative correlation was found between the mean scores of MAAS and TBPS of pregnant women. The trimester of pregnancy, listening to the birth story, planned pregnancy, and traumatic birth perception, was a significant predictor of maternal antenatal attachment. As the maternal antenatal attachment levels of pregnant women increased, their perceptions of traumatic birth decreased.

Validity of the Maternal Antenatal Attachment Scale-Spanish Version for Mexican Pregnant Women

During pregnancy, parents experiment emotions, thoughts, and behaviors related to their unborn child as precursors of attachment in the caretaker-infant dyad. The Maternal Antenatal Attachment Scale (MAAS) is an instrument that has shown adequate psychometric properties to evaluate this construct in developed countries. The aim of this study was to assess the reliability and concurrent validity of the Maternal Antenatal Attachment Scale-Spanish version for Mexican women (MAAS-Spanish version). A sample of 142 women in their third trimester of pregnancy who received care in a tertiary hospital was selected. The full scale of the MAAS-Spanish version obtained a Cronbach alpha of .79. A significant negative correlation was found between the global MAAS-Spanish version score (r = -.23, p ≤ .01) and the Postpartum Depression Predictors Inventory-Revised and depressive symptoms (r = -.36 , p ≤ .01). The translated and adapted scale has adequate internal consistency and concurrent validity to measure this construct in this population.

Maternal-fetal attachment as a natural phenomenon of pregnancy and maternity development: A review

Pregnancy is the most important stage in the formation of motherhood, maternal programming. An integral component of this process is maternal-fetal attachment, which can be defined as the bonds between a woman and a fetus that depend on the cognitive and emotional abilities to perceive another human being and include thoughts, behavior, emotions and relationships. The formation of maternal-fetal attachment is presumably due to the high plasticity of the brain of a pregnant woman, which results in significant structural and functional changes in its individual structures. The study of maternal-fetal attachment is possible using standardized questionnaires, one of which is the Maternal Antenatal Attachment Scale. The paper provides the Russian version of this questionnaire and its reference values. Maternal-fetal attachment depends on the personality characteristics of the woman and, to a lesser extent, on socio-demographic factors, and its characteristics have a prognostic value for the psychological and somatic health of the mother and child. Assessment of maternal-fetal attachment and its optimization should be considered as an integral component of medical and psychological support for pregnant women.

Associations of maternal antenatal bonding with neonatal meconium microbiota and the behavior temperament of infants: A prospective longitudinal study

Exposure to a poor intrauterine environment, such as maternal prenatal stress, has been linked to gut microbiota health in infants. Understanding the link between maternal prenatal bonding, early gut microbiota, and neuropsychological development may promote healthy development in early life. This study included 306 mother-child pairs. Women were assessed for maternal antenatal bonding using the Maternal Antenatal Attachment Scale in all three trimesters of pregnancy. Neonatal meconium samples were collected after birth. The behavioral temperament of infants was measured using the Very Short Form of the Infant Behavior Questionnaire–Revised at 6 months postpartum. Maternal prenatal bonding was negatively associated with the infants' relative abundance of Burkholderia and was positively associated with the relative abundance of Bifidobacterium, infant surgency and effortful control. The infant's relative abundance of Burkholderia mediates the association between maternal prenatal bonding and effortful control of the infant. This study provides new evidence about the long-term behavioral implications of a prenatally positive intrauterine environment in offspring microbiomes. The integration of maternal bonding assessment and intervention into prenatal healthcare and wellness models may modulate the establishment of gut microbiota in early life and long-term neuropsychological development in infants.

Virtual Prenatal Care: The Effect of Telemedicine and Home-Ultrasound on Maternal Anxiety and Attachment During Pregnancy in Women With a History of Pregnancy Loss [ID: 1375930

INTRODUCTION: We aimed to study the effects of twice-a-week telemedicine visits on maternal anxiety and antenatal attachment in women with a history of previous pregnancy loss by complementing routine prenatal care with home ultrasound. METHODS: This was a randomized controlled trial. Women with history of pregnancy loss (>20 weeks) were recruited and randomized 1:1 in the treatment arms early in their subsequent pregnancy in our high-risk clinic. The control group received routine prenatal high-risk care per protocol, while the study group received additional twice-a-week telemedicine visits with a maternal–fetal medicine specialist, which included a home ultrasound scan (for fetal heart rate, movement, and amniotic fluid) for reassurance. The scan was performed by the patient using a home ultrasound device (Pulsenmore ES) with physician authorization and guidance. Maternal anxiety was evaluated by the validated State-Trait Anxiety Inventory Scale (STAI-S) and maternal attachment was evaluated by the validated Maternal Antenatal Attachment Scale (MAAS-2) at four time points throughout pregnancy. The primary outcome was the STAI-S score at the last prenatal visit. Power analysis required 40 patients to demonstrate a 20% difference in the primary outcome. The study was approved by the local IRB, and all patients signed an informed consent upon randomization. RESULTS: To date, 32 patients completed follow-up, with 16 per arm. There were no differences in demographics or pregnancy outcomes between groups. The study group demonstrated lower anxiety levels at the last prenatal visit (STAI 42.2±4.7 versus 49.6±5.8, P<.001), higher differences between STAI scores at the first versus last visit (−9.9±2.7 versus −7.1±3.1, P=.011), and higher MAAS-2 scores (50.4±3.9 versus 47.2±4.5, P=.039) at last visit. CONCLUSION: Routine prenatal telemedicine visits with home ultrasound can lower maternal anxiety and improve attachment in women with previous pregnancy loss.

Maternal Prenatal Distress, Maternal Pre- and Postnatal Bonding and Behavioral and Emotional Problems in Toddlers. A Secondary Analysis of the IRIS Study

Maternal prenatal distress (i.e., anxiety and depressive symptoms) increases the risk for childhood behavioral and emotional problems. So far, the potential role of maternal bonding in this association still needs further study. Maternal prenatal distress can affect the development of maternal bonding from pregnancy onwards. Maternal prenatal and postnatal bonding in turn have been shown to predict child behavioral functioning. We aimed to investigate whether maternal prenatal and postnatal bonding mediate the association between maternal prenatal distress and toddlers’ internalizing and externalizing problems. Data from a Dutch prospective longitudinal sample (N = 666) were used to conduct single and multiple mediation models. Mothers reported prenatal anxiety (State Anxiety Inventory) and prenatal depressive symptoms (Edinburgh Postnatal Depression Scale) at 24 weeks’ gestation and maternal prenatal bonding (Maternal Antenatal Attachment Scale) at 32 weeks’ gestation. At 6 weeks and 6 months postpartum mothers completed questionnaires to assess maternal postnatal bonding (Maternal Postnatal Attachment Scale). Mothers reported child internalizing and externalizing problems (Child Behavior Checklist) at 28 months postpartum. Maternal prenatal and postnatal bonding mediated the link between maternal prenatal anxiety and child externalizing problems but not internalizing problems. Only maternal bonding 6 months postpartum mediated the link between maternal prenatal depressive symptoms and child internalizing problems but not externalizing problems. Our study showed that maternal postnatal bonding more consistently mediated links between measures of maternal prenatal distress and child behavioral and emotional problems than maternal prenatal bonding. Interventions reducing maternal prenatal distress and promoting maternal bonding should be developed.

A STUDY TO ASSESS THE PERCEPTION OF MATERNAL FETAL ATTACHMENT DURING ANTENATAL PERIODS AMONG ANTENATAL MOTHERS BY USING HINDI VERSION OF MATERNAL ANTENATAL ATTACHMENT SCALE (19-ITEMS) IN A SELECTED HOSPITAL OF DELHI.

Introduction: The link between a mother and her unborn child normally develops from the moment they are conceived. Two-thirds of women may report a strong maternal relationship by the time their baby moves for the rst time at 18 to 25 weeks. The developing fetus is completely reliant on her mother for all of her basic requirements; the fetus can hear and respond to the mother's heartbeat and voice, as well as touch and movement. The aim of the study was to assess the perception of maternal fetal attachment during antenatal periods among antenatal mothers by using Hindi version of MAAS (19-items). Methods: The quantitative research approach with a pre- experimental one group post test design was selected. 60 antenatal mothers, 31-40 weeks of gestation were selected purposive sampling technique from Jag Pradesh Chandra Hospital, Shastri Park Delhi. MAAS (19-items) Hindi version was used to collect the data. The data obtained was tabulated in Microsoft Excel Spread Sheet and was analyzed in terms of objective of the study using descriptive and inferential statistics. Results: The ndings revealed that majority of the mothers were having very good attachment (46.6%) with their fetus, followed by (6.6%) of the mother who were having excellent attachment to the fetus, whereas (33.3%) good attachment and (13.3%) average attachment of the mothers to their fetus. The ndings revealed that the mean scores maternal fetal attachment during antenatal periods among antenatal mothers is 74.6 is just around the middle of the scores range 54-95 indicating very good attachment of the mothers to their fetus. Conclusion: The maternal antenatal attachment scale has been demonstrated to be an effective instrument for predicting attachment between the mother and her unborn child, and it may be useful in diagnosing postnatal complications early on.

A Cross-Sectional Study of the Marital Attitudes of Pregnant Women at Risk for Cystic Fibrosis and Psychological Impact of Prenatal Screening.

Cystic fibrosis (CF) is one of the most frequent genetic disorders in those with Northern European ancestry. Prenatal testing for cystic fibrosis may be used to plan and prepare for the birth of a child with the disease or to determine whether to terminate the pregnancy. The accessibility of prenatal detection for women with a high genetic risk of delivering a child with cystic fibrosis is determined by CF carriers and those affected by the disease. Moreover, prenatal testing for CF is mainly dependent on invasive diagnostic tests that can influence the mental health of the pregnant woman, and it is assumed that the birth of a CF child will have a serious influence on the couple’s subsequent family planning and marital behavior. The purpose of this research was to examine the marital attitudes of women at risk for cystic fibrosis and the psychological effect of screening for CF among pregnant women. The study followed a cross-sectional design with five questionnaires comprising Prenatal Attachment Interview (PAI), Maternal Antenatal Attachment Scale (MAAS), Pregnancy-Related Anxiety Questionnaire (PRAQ-R2), the Prenatal Psychosocial Profile (PPP), and the Marital Intimacy Questionnaire (MIQ). A total of 84 pregnant women were included in the “carriers” group for CFTR and 91 in the “non-carrier” group. CFTR-carrier mothers were likely to be more affectionate to the fetus, with better maternal–fetal quality and intensity of attachment. The same group of pregnant women was less scared of giving birth or worried about bearing a physically or mentally handicapped child compared to women who were expecting the prenatal diagnosis test for being at risk of delivering a newborn with malformations. CFTR-carrier pregnant women did not score significantly different results in the Prenatal Psychosocial Profile regarding stress levels, social support, and self-esteem. It was also found that intimacy and consensus problems inside the marriage were significantly more often experienced by CFTR carriers. Based on the current findings, it is likely that CFTR-carrier mothers have a better perception of the possible pregnancy outcomes by knowing their abnormal gene carrier status. Therefore, the psychological impact of invasive diagnostic tests is lower in this category compared with those who are unaware of the possible pregnancy outcomes. However, we promote a future analysis for pregnant women with moderate risk of giving birth to a child with single-gene mutations such as cystic fibrosis or other congenital malformations that undergo noninvasive prenatal diagnosis tests, as they become more accurate and might cause lower pre-diagnosis stress levels.

The Role of Antenatal and Postnatal Maternal Bonding in Infant Development.

The affectional bond experienced by a mother toward her developing fetus/infant has been theorized to be a critical factor in determining infant developmental outcomes; yet there remains a paucity of research in this area, and a lack of high-quality longitudinal studies. This study aimed to examine the extent to which mother-to-infant bonding predicted infant development in a multi-wave longitudinal pregnancy cohort study (N= 1,347). Self-reported bonding was assessed using the Maternal Antenatal Attachment Scale at each trimester, and the Maternal Postnatal Attachment Scale at 8 weeks and 12 months postpartum. Infant development was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 12 months. Bonding predicted indicators of infant social-affective development, including social-emotional, behavioral, and temperamental outcomes. Effect sizes ranged from small to moderate, increasing over the perinatal period (β= 0.11-0.27). Very small effects were also identified in the relationship between bonding and cognitive, language, and motor development (β= 0.06-0.08). Findings suggest that a mother's perceived emotional connection with her child plays a role in predicting social-affective outcomes; prediction may not extend to other domains of infant development. Maternal bonding may therefore be a potentially modifiable predictor of infant social-affective outcomes, offering important considerations for preventive intervention.

Does interactive ultrasound intervention relieve minor depressive symptoms and increase maternal attachment in pregnancy? A protocol for a randomized controlled trial

BackgroundPerinatal depression, especially minor depression, is common during pregnancy and is likely to continue into the postpartum period. It may impair the mother’s health, the infant’s neurodevelopment, and the mother-infant relationship. Screening for perinatal depression is recommended; however, there is no consensus on how to treat depressive symptoms while simultaneously supporting the mother-infant relationship. Ultrasound examination has been shown to improve maternal-fetal attachment among pregnant women. Our aim is to develop a four-dimensional (4D) based interactive ultrasound intervention and test whether it relieves minor depressive symptoms and improves maternal-fetal attachment. Previous studies show that supporting the mother-infant relationship aids in relieving maternal depression. Until now, few studies have combined pregnancy ultrasound and psychological support.MethodsA controlled randomized setting was designed to assess whether interactive 4D-ultrasound intervention would decrease maternal depressive symptoms, strengthen maternal-fetal attachment, and mother-infant relationship. An obstetrician and a psychologist specialized in infant mental health conduct the interventions. The focus is to jointly observe the behavior of the fetus according to the mothers’ wishes. Altogether, 100 women scoring 10–15 on Edinburgh Pre-/Postnatal Depression Scale (EPDS) and with singleton pregnancy are recruited using a web-based questionnaire. Half of the participants will be randomized to the intervention group and will undergo three interactive ultrasound examinations. The primary outcomes are a decrease in perinatal depressive symptoms assessed with EPDS and an increase in maternal attachment. The maternal attachment was assessed using the Working Model of the Child Interview (WMCI), the Maternal Antenatal Attachment Scale (MAAS), and the Maternal Postnatal Attachment Scale (MPAS). Secondly, we hypothesize that if the intervention decreases prenatal depressive symptoms and improves prenatal attachment, the decrease in depressive symptoms and improvement in mother-infant relationship is seen postnatally.DiscussionUltrasound is widely used during pregnancy. The interactive approach is unique and may be feasible as part of routine screenings and maternity clinic visits. Intervention that decreases depression and simultaneously supports maternal-fetal attachment would be a valuable addition to the treatment of minor depression among pregnant women.Trial registrationClinicalTrials.gov NCT03424642. Registered on January 5 2018.

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

ABSTRACT 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 R 2 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 Parents under Pressure parenting programme for families with fathers receiving treatment for opioid dependence: the PuP4Dads feasibility study

Background The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research. Objective To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted. Design A mixed-methods feasibility study. Setting Two non-NHS family support services for parents who use drugs in Scotland. Participants Fathers prescribed opioid substitution therapy (n = 25), their partners (n = 17) and children, as well as practitioners, supervisors, service managers and referrers. Intervention A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners. Main outcome measures Feasibility progression criteria included the recruitment target (n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events. Data sources The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers (n = 23), mothers (n = 14), practitioners (n = 8), supervisors (n = 2) and service managers (n = 7); conducted focus groups with referrers (n = 28); and held an ‘expert event’ with stakeholders (n = 39). Results The PuP4Dads was successfully delivered within non-NHS settings and was considered acceptable and suitable for the study population. Referrals (n = 44) resulted in 38 (86%) eligible fathers, of whom 25 (66%) fathers and 17 partners/mothers consented to participate. Most fathers reported no previous parenting support. A total of 248 sessions was delivered to the 20 fathers and 14 mothers who started the intervention. Fourteen fathers (and 10 mothers) completed ≥ 6 sessions and six fathers (and four mothers) completed ≤ 5 sessions. Father and mother attendance rates were equal (mean 71%). Median length of engagement for fathers was 26 weeks and for mothers it was 30 weeks. Twenty-three fathers completed interviews at baseline, 16 fathers completed interviews at follow-up 1 and 13 fathers completed interviews at follow-up 2. Outcome measures were well tolerated; however, the suitability of some measures was dependent on family circumstances. The researcher-administered questionnaires had few missing data. The perceived benefits of PuP4Dads reported by parents, practitioners and managers included the following: the therapeutic focus on fathers improved parental emotion regulation, there was improved understanding and responding to child’s needs, there was better multiagency working and the programme was a good fit with practice ‘ethos’ and policy agenda. Learning highlighted the importance of service-wide adoption and implementation support, strategies to improve recruitment and retention of fathers, managing complex needs of both parents concurrently, understanding contextual factors affecting programme delivery and variables affecting intervention engagement and outcomes. Limitations Lack of emotional availability and economic (service use) data. Conclusions A larger evaluation of PuP4Dads is feasible. Future work Further work is required to demonstrate the effectiveness of PuP4Dads and the cost implications. A better understanding is needed of how the intervention works, for whom, under what circumstances and why. Trial registration Current Controlled Trials ISRCTN43209618. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.

Перевод и адаптация методики «Пренатальная привязанность матери к ребенку» (MAAS)

Introduction. The article presents the results of adaptation and validation of the Russian-language version of the Maternal antenatal attachment scale (MAAS) by J. Condon «Maternal prenatal attachment». This scale is aimed at studying the relationship of a mother to a child during pregnancy (quality of attachment, attachment behavior). Method. The study sample consisted of 320 pregnant women aged 18—44 years (average age — 27.1 years), gestational age — from 8 to 39 weeks (average 26.8 weeks). Results and conclusions. The Russian-language version of the scale was checked for internal consistency (Cronbach’s α coefficient — 0.83). Testing of constructive validity using Pregnant women attitude test, Relationship color test and Family drawing showed a close correlation with indicators of attitude towards the child. In addition to the original version of the method processing, a second version of the method processing was proposed — in accordance with the structure of prenatal attachment (cognitive, emotional and behavioral components).

The influence of being pregnant during the COVID-19 pandemic on birth expectations and antenatal bonding

ABSTRACT Purpose The aim of the present study was to compare birth expectations and antenatal bonding of women pregnant prior to and during the COVID-19 pandemic. Materials and methods In total, 74 pregnant women (mean age: 33.9 ± 4.1 years, gestational age: 36 ± 2 weeks) participated in the study, who were pregnant either during the the COVID-19 pandemic (corona group, N = 35, April–July 2020) or before the pandemic (control group, N = 39, October 2017–January 2019). Birth expectations were measured using the Wijma Delivery Expectancy Questionnaire (WDEQ) and Salmon’s Item List (SIL) and antenatal bonding with the Maternal Antenatal Attachment Scale (MAAS). Additionally, the corona group indicated their level of worry regarding different pandemic-related aspects using visual analogue scales. Results The corona group displayed significantly elevated fear of childbirth measured by the WDEQ and lower antenatal bonding quality compared to the control group. The additional items regarding COVID-19 burdens highlighted that the aspects that the partner may not be present during labour and that no visitors will be allowed in hospital were associated with the highest worries. Conclusions Midwives and gynaecologists should be aware of the negative impact of the COVID-19 pandemic on fear of childbirth and antenatal bonding .

Maternal\u2013fetal attachment in pregnant Italian women: multidimensional influences and the association with maternal caregiving in the infant\u2019s first year of life

BackgroundMaternal–Fetal Attachment (MFA) describes the cognitive-representational, emotional, and behavioral aspects of the mother–fetus relationship that develops during pregnancy.We present two studies conducted on pregnant Italian women. In Study I, we aimed to explore multifaceted associations of MFA with variables important for a healthy pregnancy (e.g., maternal mental health, the couple’s relationship). In Study II, we investigated the predictive role of MFA on observed maternal caregiving during the first months of the infant’s life.MethodsIn Study I, 113 pregnant Italian women were assessed on MFA (Maternal Antenatal Attachment Scale, MAAS), maternal depression (Beck Depression Inventory-II, BDI-II), maternal anxiety (State Trait Anxiety Inventory – State version, STAI), adjustment of the couple (Dyadic Adjustment Scale, DAS), and perceived parental care (The Parental Bonding Instrument, PBI). In Study II, 29 mother–infant pairs were followed up at 4 months to assess observational variables of maternal caregiving through the Emotional Availability Scale (EAS) and to test for an association with MFA in pregnancy.ResultsStudy I showed a significant association between MFA and the quality of the couple relationship (β = .49, P < .001) and between MFA and the recall of memories of care received in childhood (β = .22, P = .025). Study II showed a predictive effect of MFA on maternal structuring observed during mother–infant interactions at 4 months of age (β = 0.36, P = .046).ConclusionThe study points out relevant relationship contexts that might receive care and support throughout pregnancy to protect MFA. The findings also provide thoughtful insights on the role of MFA in early maternal caregiving, suggesting that MFA might be a candidate as one putative antecedent of mother–infant interaction processes.

Effect of Fetal Movement Count Training (FMCT) on Prenatal Bonding and Maternal Anxiety among Primigravida Women

Background: Fetal movements can have positive effects on maternal-fetalattachment beforebirth, because the fetusis more tangible with the mother after movement. Daily fetal movementcounting is a simple and non-invasive method that can be carried out by the mother in order to improve thematernal fetal attachment and toreduce the maternal anxiety for the better pregnancy outcome.Objectives: The main objective of the study was to assess the effect of fetal movement count training onprenatal bonding and maternal anxiety among primigravida.Methods: Quantitative approach with true experimental research design was adopted. Total 173 pregnantwomen were selected for the study using purposive sampling technique. Subjects were randomly assignedin to the experimental (n=87) and control group (n=86). Fetal movement count training was given toexperimental group. The training includes both instructions and demonstration on fetal movement count.Booklet contain the steps of fetal movement count and 28 days counting chart was provided to the pregnantwomen to make the them adhere to the count.The tools used to collect the data were as follows: (1)Demographic questionnaire, (2) Maternal Antenatal Attachment Scale and (3) Self structured Anxiety Scale.Baseline assessment was done on the 1stday and the training was implemented on the same day. Motherswere followed through phone calls. Post-assessment was done after 28days. The data wereanalysed usingdescriptive and inferential statistics.Result: The mean post-test prenatal bonding score in experimental group is 81.90±5.969 and in controlgroup is 77.57±7.459 which shows the significant difference in prenatal bonding score between both thegroups (t = 4.215 p = 0.00002). The mean post-test maternal anxiety score is prenatal bonding score inexperimental group is 34.69±6.719 and in control group is 35.17±6.809 which is not showing any significantdifference between both the groups (t = 0.471 p = 0.3191). There was a moderately negative correlationfound between pre-test prenatal bonding and maternal anxiety score as evidenced by r= -0.277 at p=0.0002which was statistically significant.Conclusion: Thus, the training regarding fetal movement count was effective in improving prenatal bondingand reducing maternal anxiety among primigravida.

Maternal Antenatal Attachment Scale (MAAS) reference values at different stages of pregnancy and their possible associations with major obstetric and demographic characteristics

ABSTRACT The study was aimed to explore the values of maternal-fetal attachment (MFA) at different stages of pregnancy using Maternal Antenatal Attachment Scale (MAAS) with the construction of reference percentile curves and to examine possible associations between the measures of MFA and major demographic and obstetric characteristics. The study covered 530 pregnant women aged 18 through 50 years, gestational age 4 through 41 weeks. Reference percentile curves were constructed. No associations were found between gestational age and the values of the MAAS subscales. Primigravida had higher intensity and MAAS total scores; women having previous abortions had lower intensity and MAAS total scores; primipara had higher intensity score, and women with intended pregnancy had higher values on the quality, intensity and MAAS total scores. Early evaluation of MFA is appropriate for most pregnant women and may be useful indicator for early clinical and psychological intervention.

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

BackgroundPrenatal 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.MethodsThe 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.ResultsThe 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.ConclusionsPrimigravida 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.