Maternal-fetal Attachment Research Articles

Indigenous Australian Perspectives on the Perinatal Period: Social Well-Being, Culture and Early Infant Attachments

ObjectiveAlthough social factors and culture are significant determinants of health in Aboriginal and Torres Strait Islander peoples, little is known academically about key interpersonal and social experiences of this population during the perinatal period, or how early attachments are formed through culture. This study addressed this gap in the literature. Methods and MeasuresA reflexive thematic analysis approach was applied to the data gathered from focus groups (N = 14) held with Aboriginal (N = 7) and Torres Strait Islander (N = 7) mothers and their kinship systems. ResultsFive prominent interpersonal and social themes were identified: maternal-fetal attachment, infant-kinship attachment, caretaking roles/shared caregiving, traditional adoption, and ceremonies and rites of passage. Characteristics of maternal-fetal attachment were aligned with the construct in non-Indigenous literature. Post-utero, caretaking/shared caregiving roles such as ‘big mum/dad’ and ‘small mum/dad’ were identified. Ceremonies and rites of passage were understood to cement cultural roles within the kinship system, and the role of the maternal uncle was highlighted. A cultural obligation to help raise the child for biological mothers’ other siblings, known as ‘mums’ and ‘dads’, was identified. ConclusionDiscussion is centred around the necessity for ‘grass roots’ research from the perspectives of Aboriginal and Torres Strait Islanders, and on suggestions for future research in further exploring the themes derived from this research.

The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal-Fetal Attachment in Primigravida Women.

To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal-fetal attachment in primigravida women. A multi-site cross-sectional research design study. This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal-Fetal Attachment Scale (MFAS-HU-20). The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal-fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal-fetal attachment tends to decrease. The correlations range from -0.263 to -0.426, all significant at p < 0.001. The emotional impact of climate change can adversely affect the bonding process between mother and fetus. Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers. The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women. The research adhered to that is STROBE. Public contributions by women in community health centers.

Perceptions of primigravida and their husbands regarding the need for maternal-fetal attachment stimulation

Prenatal class programs for primigravidas are important to improve fetal care behavior and reduce infant mortality. In prenatal classes, there is no maternal-fetal attachment stimulation education program which is important for improving maternal-fetal attachment and fetal well-being. The perceptions of pregnant women and their husbands regarding knowledge and experience of pregnancy as well as maternal-fetal attachment (MFA) stimulation are important for assessing the need for MFA educational materials. The research aimed to examine the perceptions of primigravidas and their husbands regarding pregnancy and MFA stimulation. Exploratory descriptive qualitative study method. Data were collected using in-depth interviews with 10 primigravidas and their husbands at the Community Health Center in Bantul, Yogyakarta, Indonesia, using an interview guide. Data analysis by condensing data, presenting data, and drawing conclusions, verbatim results of interviews are presented in coding, found categories, and themes. Four themes were produced: knowledge of pregnancy and fetal growth and development; concept of maternal-fetal attachment skills; management of pregnancy emotional management; and husband's support. The conclusion of this theme's findings underlies the development of maternal-fetal attachment educational materials in prenatal classes to prepare mothers for their role, and improve MFA and maternal-fetal health.

The Effect of Haptonomy on Fear of Childbirth and Maternal-fetal Attachment: A Systematic Review and Meta-analysis

Background: Haptonomy is considered one of the non-pharmacological interventions in reducing Fear of Childbirth (FOC) and increasing Maternal Fetal Attachment (MFA). No review study has been conducted for an evidence-based conclusion in this regard. Objective: This study aimed to evaluate the pooled effect of haptonomy on FOC and MFA. Methods: A systematic literature search was conducted in an electronic database (Scopus, Cochrane Library, Clinical Trials.gov, Embase, ProQuest, PubMed, Google Scholar, Web of Science, SID, and Magiran) until January 30th, 2023, to find all interventional studies that reported the effect of haptonomy on FOC and MFA. Results: A total of 26 relevant articles were retrieved in the search, of which 4 articles were included in the systematic review. Meta-analysis was conducted for three research studies with the outcome of FOC and three studies with the outcome of MFA. The metaanalysis of three research conducted on 239 participants indicated the positive effect of hatonomy intervention on reducing FOC (MD: -22.91; 95% CI: -28.21 to -17.61; p &lt; .001 ), and owing to the moderate heterogeneity, the random effect model was used (I2 = 41.38%). The results of the meta-analysis of three research with 286 participants indicated the ineffectiveness of haptonomy intervention on the MFA (MD: 4.35; 95% CI: - 2.72 to 11.42; p = .23) (I2 = 59.95%). Conclusion: Haptonomy intervention during pregnancy reduces FOC without playing any role in increasing MFA. However, conducting the clinical trials with a larger sample size by means of standard tools is recommended due to the limited number of haptonomy interventions on MFA and the moderate heterogeneity of reviewed studies.

Maternal-fetal attachment during pregnancy at the Public Health Center

Maternal-fetal attachment during pregnancy at the Public Health Center

High-risk Pregnancy Nursing: Analyzing the Impact of Prenatal Stress, Maternal-Fetal Attachment, and Social Support on Prenatal Depression

Background The purpose of this study is to examine the effects of pregnancy stress, maternal-fetal attachment, and social support on prenatal depression among high-risk pregnant women. This research aims to provide foundational data to assist in preventing prenatal depression in high-risk pregnant women within the nursing field. Methods A study was conducted on 141 high-risk pregnant women diagnosed as high-risk and hospitalized, who were less than 37 weeks pregnant. The study investigated pregnancy stress, maternal-fetal attachment, social support, and general characteristics. The collected data were analyzed using the SPSS WIN 22.0 software, employing methods, such as frequency, percentage, standard deviation, t-test, one-way ANOVA, Pearson's correlation coefficient, Scheffé test, and hierarchical multiple regression analysis. Results The participants showed a positive correlation between prenatal depression and pregnancy stress (r= 0.51, p&lt; 0.001) and negative correlations with maternal-fetal attachment (r=- 0.38, p&lt; 0.001) and social support (r=- 0.50, p&lt; 0.001). Regression analysis revealed that the relationship with the spouse (β=-0.42, p= 0.006), a family history of depression (β= 0.35, p&lt; 0.001), pregnancy stress (β= 0.30, p&lt; 0.001), and maternal-fetal attachment (β=- 0.15, p= 0.033) significantly influenced prenatal depression in that order, with an explanatory power of 52% (F=16.04, p&lt;0.001). Conclusion In managing prenatal depression in high-risk pregnant women, it is essential to identify individuals with strained relationships with their spouses or a family history of depression. Furthermore, implementing educational and nursing intervention programs designed to reduce pregnancy stress and encourage maternal-fetal attachment behaviors is crucial.

THE RELATIONSHIP BETWEEN PARENTS' PRENATAL FETAL GENDER PREFERENCE AND PRENATAL ATTACHMENT: AN ANALYTICAL AND CROSS-SECTIONAL STUDY

This study aimed to determine the relationship between the fetal sex preferences of pregnant women and fathers and their prenatal levels of attachment to the fetus. This analytical and cross-sectional study was carried out with 152 married couples between 07/01/2022 and 02/01/2023. The study data were collected using information forms prepared for pregnant women and prospective fathers, the Maternal-Fetal Attachment Inventory (MFAI) for pregnant women, and the Paternal Antenatal Attachment Scale (PAAS) for prospective fathers. In the study, it was determined that attachment related to some individual and fetal sex characteristics of pregnant women and prospective fathers was correlated and that male fetal sex increased the levels of prenatal attachment in both pregnant women and prospective fathers (p

Comparison of maternal-fetal attachment, anxiety, depression, and prevalence of intimate partner violence in Iranian women with intended and unintended pregnancy: a cross-sectional study

BackgroundUnintended pregnancies and intimate partner violence can adversely affect women, infants, and their psychological well-being. The study aimed to compare depression, anxiety, maternal-fetal attachment, and the prevalence of intimate partner violence between women with and without unintended pregnancies in Tabriz, Iran. The study sought to address the lack of research on this topic in the Iranian context.MethodsThis cross-sectional study was conducted on 486 pregnant women attending health centers in Tabriz City between 2022 and 2023. A cluster sampling method was utilized, and data were gathered through the administration of socio-demographic, Maternal Fetal Attachment, Edinburgh Postnatal Depression, World Health Organization Domestic Violence, and Pregnancy Anxiety instruments. A general linear model (GLM), controlling for potential confounding variables, was used to compare anxiety, depression, and maternal-fetal attachment between the two groups. Multivariable logistic regression analysis, also controlling for potential confounding variables, was employed to compare the prevalence of domestic violence between the two groups.ResultsThe results of the adjusted GLM indicated that women with unintended pregnancies had significantly lower maternal-fetal attachment (Adjusted mean difference (AMD):-9.82, 95% CI:-12.4 to -7.15 ; p < 0.001)), higher levels of depression (AMD: 2.89; CI: 1.92 to 3.86 ; p < 0.001), and higher levels of anxiety (MD: 5.65; 95% CI: 3.84 to 7.45; p < 0.001) compared to women with intended pregnancies. During pregnancy, 40% of women with unintended pregnancies and 19.2% of women with intended pregnancies reported experiencing at least one form of physical, sexual, or emotional violence. The results of the adjusted multivariable logistic regression revealed that women with unintended pregnancies had a significantly higher odds of experiencing emotional violence (adjusted odds ratio [aOR]: 2.94; 95% CI: 1.64 to 5.26; p < 0.001), sexual violence, (aOR: 2.25; 95% CI: 1.32 to 3.85; p = 0.004), and physical violence (aOR: 2.38; 95% CI: 1.50 to 3.77; p < 0.001) compared to women with intended pregnancies.ConclusionsThe study found that women with unintended pregnancies had lower levels of maternal-fetal attachment, higher levels of anxiety and depression, and a high prevalence of intimate partner violence, including physical, sexual, and emotional violence, compared to women with intended pregnancies. These results emphasize the importance of implementing policies aimed at reducing unintended pregnancies.

Effects of Mindfulness-Based Practices in the Perinatal and Postpartum Periods on Women's Health: A Systematic Review

The aim of this systematic review was to evaluate the effects of mindfulness interventions on women's mental health in the perinatal and postpartum period. In the study, randomized controlled studies published in the last five years, from January 2018 to September 2023, were searched in CINAHL, PubMed, Cochrane Library, Science Direct, and Springer Link databases. The keywords "Pregnancy", "Pregnant", "Prenatal", "Perinatal", "Postpartum", "Mindfulness", "Meditation", "Self-compassion" and "Randomized controlled trial" were used while searching the databases. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's Critical Appraisal Checklist for Randomized Controlled Trials. As a result of the search, 26 studies were found. The studies revealed that the most commonly applied mindfulness intervention among intervention groups was self-help programs in an online setting. Mindfulness-based practices significantly impacted women's mental health, reducing fear of childbirth, depression, anxiety, and stress levels, while enhancing psychological well-being, self-efficacy, self-compassion, and mindfulness. Furthermore, these practices also benefited women’s physical health, contributing to higher rates of normal vaginal births and increased maternal-fetal attachment. They were found to lessen birth pain, reduce the need for medication or anesthesia, and support the adoption of healthy lifestyle behaviors. These findings suggest that mindfulness interventions, which positively influence the mental health of both mothers and infants, should be widely applied to women, and the results of this study should be disseminated.

Factors Related to Maternal-fetal Attachment in Pregnant Mothers: An Analytical Cross-sectional Study

Aim:: The study investigated the relationship between Determining the Factors Related to Maternal-Fetal Attachment in Pregnant Mothers with Maternal-Fetal Attachment. Background:: Demographic policies in Iran emphasize population, fertility, and maternal health. Maternal-fetal attachment (MFA) is a term used to describe conditions that help the mother cope with the physiological changes during pregnancy. MFA contributes significantly to the future health of mother and child. Thus, it is essential to identify the nature of maternal-fetal attachment during pregnancy, when women need to prepare for and adapt to childbirth. The present study was conducted to determine the factors related to maternal-fetal attachment in pregnant mothers of Arak City. Objectives:: The study investigated the relationship between obstetric-demographic factors, emotional intelligence, marital satisfaction, and domestic violence with maternal-fetal attachment. Methods:: The present cross-sectional study was conducted on 177 pregnant mothers with a gestational age of 37-40 who were referred to health centers in Arak, Iran, for pregnancy care in 2022. Five questionnaires, including an obstetric-demographic questionnaire, Cranley's Standard Mother-Fetal Attachment Scale, Schutte Self-Report Emotional Intelligence Test, ENRICH marital satisfaction scale, and HITS domestic violence questionnaire, were used to measure the factors related to maternal-fetal attachment. Data were analyzed using SPSS21 software and descriptive and analytical statistics, including frequency distribution, Pearson correlation, t-test, Chi-square, Analysis of variance (ANOVA), and Multiple Logistic Regression model. Results:: The mean of age women and age of husbands was 29.07± 5.88 years and 32.93± 5.28 years, respectively. The mean maternal-fetal attachment score was 88.12± 15.76. The mean of the emotional intelligence, the marital satisfaction and, the domestic violence was 4.71± 2.81, 121.88± 17.30, 37.86± 7.25, 6.54± 3.35, respectively. The interval between the current and the previous pregnancy had a range of 1-7 years and a mean of 4.71± 2.8 years. : There was a positive significant correlation between the maternal-fetal attachment score and the interval between the current and the previous pregnancy (r=0.22, p=0.02), : There was a positive significant correlation between the maternal-fetal attachment score and the emotional intelligence (r=0.31, p=0.001) the marital satisfaction (r=0.25, P=0.001). There was a negative significant correlation between the maternal-fetal attachment score and the domestic violence (r=-0.26, p=0.001 Conclusion:: Identifying attachment-related factors helps the health staff carry out the necessary training and preventive measures to increase maternal-fetal attachment, especially in high-risk parents who need more care.

Human placental lactogen (human chorionic somatomammotropin) and oxytocin during pregnancy: Individual patterns and associations with maternal-fetal attachment, anxiety, and depression

Previous studies support links among maternal-fetal attachment, psychological symptoms, and hormones during pregnancy and the post-partum period. Other studies connect maternal feelings and behaviors to oxytocin and suggest that an increase in oxytocin during pregnancy may prime maternal-fetal attachment. To date, researchers have not examined a possible association between maternal-fetal attachment with human placental lactogen although animal models are suggestive. In the current study, we sought to describe oxytocin and human placental lactogen levels as related to psychological constructs across pregnancy. Seventy women participated in the study. At each of three time-points (early, mid, and late pregnancy), the women had their blood drawn to assess oxytocin and human placental lactogen levels, and they completed psychological assessments measuring maternal-fetal attachment, anxiety, and depression. Our results indicate that oxytocin levels were statistically similar across pregnancy, but that human placental lactogen significantly increased across pregnancy. Results did not indicate significant associations of within-person (comparing individuals to themselves) oxytocin or human placental lactogen levels with maternal-fetal attachment. Additionally, results did not show between-person (comparing individuals to other individuals) oxytocin or human placental lactogen levels with maternal-fetal attachment. Oxytocin levels were not associated with anxiety; rather the stage of pregnancy moderated the effect of the within-person OT level on depression. Notably, increasing levels of human placental lactogen were significantly associated with increasing levels of both anxiety and depression in between subject analyses. The current study is important because it describes typical hormonal and maternal fetal attachment levels during each stage of pregnancy, and because it suggests an association between human placental lactogen and psychological symptoms during pregnancy. Future research should further elucidate these relationships.

Investigating the Effects of Acupressure and Auriculotherapy on Anxiety During Labor, Neonatal Outcomes, and Maternal-fetal Attachment: A Systematic Review and Meta-analysis

Investigating the Effects of Acupressure and Auriculotherapy on Anxiety During Labor, Neonatal Outcomes, and Maternal-fetal Attachment: A Systematic Review and Meta-analysis

Pregnancy renders anatomical changes in hypothalamic substructures of the human brain that relate to aspects of maternal behavior

Animal studies have shown that pregnancy is associated with neural adaptations that promote maternal care. The hypothalamus represents a central structure of the mammalian maternal brain and hormonal priming of specific hypothalamic nuclei plays a key role in the induction and expression of maternal behavior. In humans, we have previously demonstrated that becoming a mother involves changes in grey matter anatomy, primarily in association areas of the cerebral cortex. In the current study, we investigated whether pregnancy renders anatomical changes in the hypothalamus. Using an advanced delineation technique, five hypothalamic substructures were defined in longitudinal MRI scans of 107 women extracted from two prospective pre-conception cohort studies, including 50 women who were scanned before and after pregnancy and 57 nulliparous control women scanned at a similar time interval. We showed that becoming a mother is associated with volume reductions in the anterior-superior, superior tuberal and posterior hypothalamus. In addition, these structural changes related to hormonal levels during pregnancy and specific aspects of self-reported maternal behavior in late pregnancy, including maternal-fetal attachment and nesting behavior. These findings show that pregnancy leads to changes in hypothalamic anatomy and suggest that these contribute to the development of maternal behavior in humans, supporting the conservation of key aspects of maternal brain circuitry and their role in maternal behavior across species.

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

&lt;b&gt;Aim:&lt;/b&gt; In this study, it was aimed to determine maternal-fetal attachment among pregnant women at risk for mental health.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; 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.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; 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&amp;lt;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&amp;gt; 0.05). The GHQ-28 mean score was lower in non-risky pregnant women (p&amp;lt;0.05).&lt;br /&gt; &lt;b&gt;Conclusion&lt;/b&gt;: 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.

A new strategy to improve maternal-fetal attachment in primigravida women with prenatal spiritual-based stimulation

Primigravida has impacts related to preparedness for the transition into motherhood. Thus, its can disrupt the attachment between the mother and the fetus. This study aimed to determine the effects of prenatal spiritual-based stimulation on maternal-fetal attachment. This study employed a quasi-experimental design with a control group and was conducted among primigravida women in Indonesia. The study included 66 respondents selected through purposive sampling. They were divided into the intervention and control groups, each comprising 33 participants. The intervention group received prenatal spiritual-based stimulations, which involved auditory, kinesthetic, light, and temperature stimulations and were administered over a 12-week period. Data on maternal-fetal attachment were collected using the Prenatal Attachment Inventory (PAI), which had been tested for validity and reliability. Approval to use the instrument was obtained from its original author. Data analysis was performed using the Wilcoxon and Mann Whitney tests. The results showed that the Wilcoxon test yielded a p-value of 0.000 or significant differences were observed before and after intervention for the intervention group and 0.059 no significant differences were observed before and after the intervention for the control group. The Mann Whitney test revealed a p-value of 0.000, there were differences in the maternal-fetal attachment before and after the intervention. Therefore, spiritual-based prenatal stimulation is effective in enhancing maternal-fetal attachment. These results can provide a basis for pregnant women to apply spiritual-based prenatal stimulation interventions to enhance maternal-fetal attachment and health status.

Investigating the impact of haptotherapy on maternal-fetal attachment in unplanned pregnancies.

Mothers who experience unplanned pregnancies tend to show less maternal attachment to the fetus, which can lead to diminished self-care during pregnancy, and affect well-being of the fetus. Consequently, unintended pregnancies are associated with heightened maternal and fetal consequences due to mothers' negligence. Hippotherapy intervention has emerged as a viable approach to enhance maternal-fetal communication. The ultimate goal of this study was to broaden our current understanding of haptotherapy's impact on maternal-fetal attachment in unplanned pregnancies. This field trial research was conducted at comprehensive health centers in Isfahan using convenient sampling method. The study consisted of two groups of mothers, each consisting of 33 individuals with unplanned pregnancies between 20 to 24 weeks. The experimental group received haptotherapy intervention for 10 weeks, while the control group received standard pregnancy care. For data collection the participants were given demographic and fertility questionnaire prior to the study, and Cranley's maternal-fetal attachment questionnaire both before and after the study. Moreover, T-test, Mann-Whitney U test, and Chi-square test were used for data analysis. Prior to the intervention, there was no significant difference in the average maternal-fetal attachment scores between the experimental and control groups (P = 0.56). However, a significant increase became apparent after the intervention. The experimental group exhibited a significant improvement in the mean attachment scores compared to their pre-intervention levels (t=-9.20, P = 0<0.001). In contrast, the control group's score remained unchanged, with no significant difference observed (=1.69, P = 0.1). Haptotherapy has been found to enhance maternal-fetal attachment in mothers experiencing unplanned pregnancies. This valuable intervention is recommended as an innovative and secure approach in maternal health care services to help reduce the potential complications associated with such pregnancies.

Maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care.

(1) Maternal-fetal attachment should be assessed in Primary Health Care. (2) Depressive symptoms were negatively related to maternal-fetal attachment. (3) Social support and family functionality had a positive effect on attachment. (4) Greater household crowding had a negative effect on the outcome. (5) It is recommended to screen pregnant women with depression, poor social and family support.

Maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care

Objetivo: analizar el apego materno-fetal y los factores interrelacionados en gestantes atendidas en la Atención Primaria de Salud. Método: encuesta epidemiológica seccional, de base poblacional y analítica. Se investigó una muestra de 937 participantes atendidas por equipos de la Estrategia de Salud de la Familia. Se evaluaron apego materno-fetal (resultado), variables sociodemográficas y clínicas, apoyo social, funcionalidad familiar, síntomas depresivos y estrés percibido. Se adoptó un análisis multivariado mediante la modelización con ecuaciones estructurales. Resultados: el apego materno-fetal presentó una media de 92,6 (DE=±15,3). El modelo estructural ajustado evidenció que los siguientes factores ejercieron un efecto directo sobre el resultado: semanas gestacionales (β=0,29; p&lt;0,001), aglomeración del domicilio (β=-0,07; p=0,027), síntomas depresivos (β=-0,11; p=0,003), apoyo social (β=0,08; p&lt;0,001) y funcionalidad familiar (β=0,19; p&lt;0,001). Se identificaron efectos indirectos del apoyo social (β=-0,29; p&lt;0,001) y de la funcionalidad familiar (β=-0,20; p&lt;0,001), mediados por los síntomas depresivos. Conclusión: se identificó un conjunto de interrelaciones entre apego materno-fetal, semanas gestacionales, aglomeración domiciliaria, síntomas depresivos, apoyo social y funcionalidad familiar. Se sugiere que la Estrategia de Salud de la Familia ofrezca una atención prenatal anclada en la integralidad y humanización, que propicie el bienestar biopsicosocial en el embarazo y un apego materno-fetal saludable.

Maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care

Objetivo: analisar o apego materno-fetal e os fatores inter-relacionados em gestantes assistidas na Atenção Primária à Saúde. Método: inquérito epidemiológico seccional, de base populacional e analítico. Foi investigada a amostra de 937 participantes, assistidas por equipes da Estratégia Saúde da Família. Avaliaram-se apego materno-fetal (desfecho), variáveis sociodemográficas e clínicas, apoio social, funcionalidade familiar, sintomas depressivos e estresse percebido. Foi adotada análise multivariada por meio da modelagem com equações estruturais. Resultados: o apego materno-fetal apresentou média de 92,6 (DP=±15,3). O modelo estrutural ajustado evidenciou que os seguintes fatores exerceram efeito direto sobre o desfecho: semanas gestacionais (β=0,29; p&lt;0,001), aglomeração do domicílio (β=-0,07; p=0,027), sintomas depressivos (β=-0,11; p=0,003), apoio social (β=0,08; p&lt;0,001) e funcionalidade familiar (β=0,19; p&lt;0,001). Foram identificados efeitos indiretos do apoio social (β=-0,29; p&lt;0,001) e da funcionalidade familiar (β=-0,20; p&lt;0,001), mediados pelos sintomas depressivos. Conclusão: identificou-se um conjunto de inter-relações entre apego materno-fetal, semanas gestacionais, aglomeração domiciliar, sintomas depressivos, apoio social e funcionalidade familiar. Sugere-se que a Estratégia Saúde da Família oferte uma atenção pré-natal ancorada na integralidade e humanização, que propicie o bem-estar biopsicossocial na gravidez e o apego materno-fetal saudável.

Avaliação psicométrica da versão brasileira da Escala de Apego Materno-Fetal

Abstract Objective This study aimed to evaluate the psychometric properties of the Brazilian version of the Maternal-Fetal Attachment Scale applied to pregnant women in Primary Health Care. Method This is a methodological study conducted with 937 pregnant women assisted in the Family Health Strategy in Montes Claros, Minas Gerais, Brazil. Psychometric sensitivity, construct and criterion validity, and reliability were evaluated. Results The instrument achieved adequate psychometric sensitivity (skewness &lt; 3 and kurtosis &lt; 7). Quality fit indicators of the model were obtained: x2/gl = 4.72, CFI = 0.89, GFI = 0.90, TLI = 0.87, RMSEA = 0.063 (90% CI = 0.059-0.067, p = 0.000). Hypothesis testing indicated associations with marital status (p = 0.036), income (p= 0.030), trimester (p &lt; 0.001), planned pregnancy (p = 0.003), social support (p &lt; 0.001), and family APGAR score (p &lt; 0.001). Significant correlations (p &lt; 0.001) with stress (r = -0.12) and depressive symptoms (r = -0.17) demonstrated divergent criterion validity. Cronbach’s α of 0.874 was recorded. Conclusion The scale showed adequate psychometric evidence for application to pregnant women in the Primary Health Care setting.