Maternal-fetal Attachment Research Articles

Relationship Between Domestic Violence in Pregnancy and Maternal Fetus Attachment

Background: Attachment between mother and fetus plays an important role in maternal identity, birth outcomes, growth, and development of a newborn. In addition, domestic violence, especially in pregnancy, has been regarded as a health priority in many societies. Objectives: The study aimed to assess the relationship between domestic violence in pregnancy and maternal fetus attachment. Methods: This descriptive correlational study was conducted on 200 pregnant mothers visiting the selected Healthcare Centers of Mashhad. The questionnaires were demographic information, Straus Violence Questionnaire and Cranley’s Mother-Fetus Attachment Questionnaire. Data were analyzed using descriptive and correlation coefficient and linear regression tests as well as SPSS v.21 software. Results: Here, 54% of members had experienced domestic violence. In general, there was a reversed and significant correlation between all aspects of domestic violence and mother-fetus attachment. Moreover, 89% of research centers reported fetal attachment as good, 10% as average, and 1% as weak. Based on the linear regression test, physical violence was able to predict the variance of maternal attachment score of 4.14% in mothers. Conclusions: As a result of this article, regarding lower maternal-fetal attachment in violated women in pregnancy, much more sensitive screening should be considered for domestic violence so that adverse outcomes are prohibited.

Antenatal mind-mindedness and its relationship to maternal-fetal attachment in pregnant women

In this study, researchers aimed to investigate whether a relationship exists between maternal-fetal attachment (MFA) and antenatal mind-mindedness in a sample of Australian pregnant women (n = 43). Participants completed the Maternal Fetal Attachment Scale (MFAS) in their second and third trimester, and a modified ‘describe your baby’ interview with the inclusion of general prompts as a measure of antenatal mind-mindedness in their third trimester. Positive correlations were observed between mental comments, but not total predictions, made by women during the modified antenatal mind-mindedness task and MFAS scores at the second and third trimesters. An average of 6.07 total predictions and 1.30 mental predictions were made before prompts, increasing to 17.65 total comments and 6.58 mental comments after prompts. Prompts within the mind-mindedness task resulted in 42 participants making at least one mental prediction (M = 6.58). Our findings provide the first evidence for a relationship between MFA and antenatal mind-mindedness, and highlight the importance of considering mind-mindedness during pregnancy in the developing bond from mother to baby.

From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective

ABSTRACT Background An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman’s and infant’s age, and difficulty of delivery. Methods 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). Results Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (β = 0.379, p < .001), anxiety in the romantic relationships (β=−0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, β=−0.323, p=0.025 ;t2, β=0.329, p=0.014) in the couple’s relationship. These variables explained 20.2% of variance in mother-infant attachment (R 2adjusted=0.202). Discussion The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman’s reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child

The Women Who Don’t Get Counted

The Women Who Don’t Get Counted

The relationship between domestic violence against women, adaptation to pregnancy and maternal-fetal antenatal attachment.

This study aimed to determine the relationship between domestic violence against women, adaptation to pregnancy, and maternal-fetal antenatal attachment. The study consisted of 385 pregnant women who were referred to the antenatal clinics of a public hospital in eastern Turkey. The data were collected using the Domestic Violence against Women Scale (DVAWS), the Maternal-Fetal Antenatal Attachment Scale (MAAS), and the Prenatal Self-Evaluation Questionnaire (PSEQ) to assess adaptation to pregnancy. Pregnant women were exposed to low level of violence (Mean ± SD: 64.42 ± 5.30). A statistically significant positive correlation was found between their DVAWS and PSEQ mean scores. There was also a statistically significant positive correlation between their DVAWS and MAAS mean scores. Findings show that as domestic violence against women increased, adaptation to pregnancy decreased and maternal-fetal attachment increased.

The relationship between prenatal attachment and postnatal adaptation, maternal anxiety and breast milk sodium level

ObjectiveTo investigate the relationship between maternal-fetal attachment and breast milk sodium (BMS) levels. MethodsThis prospective case-control study was conducted at Baskent University. Third-trimester low-risk pregnancies were included in the study. After obtaining informed consent, the Prenatal Attachment Inventory (PAI), and the State-Trait Anxiety Inventory 1 (STAI 1) and STAI 2 were administered. After delivery, BMS values were measured at regular intervals. ResultsThe mean age of the mothers and the mean gestational age were 29.6 ± 3.4 years and 38.4 ± 0.9 weeks, respectively. The mean STAI -1, STAI-2, and PAI scores were 38.2 ± 7.1, 38.8 ± 6.9, and 41.6 ± 10, respectively. When the study group was classified according to BMS levels, no differences were observed between the groups in terms of pregnancy STAI-1, pregnancy STAI-2, Muller PAI, and STAI-1 scores of the 5th, 15th, and 30th days. There was no correlation between the BMS levels on the 5th −15th days and pregnancy STAI-1, Pregnancy STAI-2, Muller PAI, and the STAI-1 scores of the 5th-10th-30th days. However, the BMS level on the 30th day had a positive significant correlation with the STAI-1 score on the 15th day (r = 0.473, p= .006). Additionally, the STAI-1 scores on the 30th day showed that there was a significant correlation with STAI-1 on the 5th day (r = 0.416, p= .015), STAI-1 on the 15th day (r = 0.497, p= .003), and breast milk sodium levels on the 30th day (r = 0.615, p< .001). ConclusionWe found no relationship between PAI scores and BMS levels on the 5th-10th-30th day but STAI scores on the 15th day and 30th day had a positive correlation with BMS levels on the 30th day. STAI-1 and STAI-2 scores during pregnancy were positively correlated with STAI scores in the postnatal period.

Sense of Coherence, Social Support, Maternal-Fetal Attachment, and Antenatal Mental Health: A Survey of Expecting Mothers in Urban India.

Introduction: Pregnancy is associated with psychological, physiological and social shifts, and can be a vulnerable time in a woman's life. Despite a growing understanding of the importance of antenatal mental health, there is a paucity of research on psychosocial factors relevant to this phase, especially in developing countries. The aim of the present study was to investigate the associations of expecting mothers' sense of coherence, perceived social support, and maternal-fetal attachment with mental health outcomes.Method: Participants (N = 122) were nulliparous expectant mothers residing in urban India. Cross-sectional data was collected using an online questionnaire.Results: Participant reports of perceived social support and sense of coherence were negatively correlated with symptoms of antenatal depression, while reports of maternal-fetal attachment, sense of coherence, and social support were positively associated with antenatal well-being. In a multilinear regression model, perceived social support and sense of coherence uniquely contributed to symptoms of antenatal depression, while maternal-fetal attachment and sense of coherence uniquely contributed to antenatal well-being.Discussion: The findings of this study highlight the role of perceived social support, sense of coherence and maternal-fetal attachment in contributing to expecting mothers' mental health and well-being in urban India. These findings have implications for clinical practice and research, intending to the subjective experiences of pregnant women to improve antenatal mental health. Future research investigating these psychosocial factors using longitudinal designs is warranted and would help clinicians and practitioners identify women at risk for perinatal mental health concerns.

The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries

BackgroundMothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergenerational transmission of risk associated with maternal ACEs. However, the extent to which prenatal depressive symptoms mediate the association between maternal ACEs and foetal attachment is unknown. MethodsData on foetal attachment, ACEs, and prenatal depression came from mothers in their third trimester of pregnancy (n = 1,185) located across eight MICs, participating in the prospective birth cohort Evidence for Better Lives Study – Foundational Research (EBLS-FR). Data were from the baseline measurement. ResultsFull-sample path mediation analyses, adjusting for relevant covariates, suggested a full mediating effect of prenatal depression. However, at the individual-country level, both positive and negative effects of ACEs on foetal attachment were observed after the inclusion of depressive symptoms as a mediator, suggesting cultural and geographical factors may influence a mother's empathic development after ACE exposure. LimitationsAs no follow-up measurements of depressive symptoms or postnatal attachment were included in the analyses, the findings cannot be extrapolated to the postnatal period and beyond. Further, causality cannot be inferred as the study was observational. ConclusionsThe findings reinforce the importance of screening for prenatal depression during antenatal care in MICs. Addressing prenatal depression within maternal health care may support foetal attachment and contribute to reducing the intergenerational transmission of disadvantage.

The Relationship between Pregnancy-related Anxiety and Maternal-fetal Attachment among Primigravida

BACKGROUND: Many studies support the hypothesis that pregnancy-related anxiety (PRA) is strongly linked to postpartum depression, preterm births, low birth weight, fetal growth restriction, pregnancy complications, and negative infant outcomes. PRA has also been associated with mother-fetal bond during pregnancy that a special relationship between the mother and infant and growth beyond before the infant is born. Although extensive studies on PRA and maternal-fetal attachment (MFA) have been carried out, little attention on these issues is done in the Indonesian context. AIM: To fill such a gap, the present study aimed to investigate the relationship between maternal PRA and MFA. METHODS: Expectant mothers who visit their antenatal care in the primary health community services at Yogyakarta participated in this study. They were recruited using a purposive sampling technique based on the criteria: (a) The 1st time pregnancy, (b) in the late stage of pregnancy, (c) have no complication, (d) mother at any age range, and (e) mother at any education level. G-power 3.1.9.2 with effect size 0.15 has used to determine the number of samples, 84 people. Statistical analysis Pearson correlation has been applied and calculates the t relationship between two variables. General linier model analysis conducted the contribution of demographic variables to PRA and MFA. RESULTS: There is a significant relationship between maternal anxiety during pregnancy and MFA (p &lt; 0.001) and a significant correlation between PRA and maternal age. However, there were no correlation between MFA and demographic variables. IMPLICATION FOR PRACTICE: Findings study provides the crucial information as the new approach to enhance the quality of care of mother’s and infant’s health during pregnancy as well as to promote maternal mental health.

The Effect of Maternal–Foetal Attachment–Based Training Programme on Maternal Mental Health Following an Unintended Pregnancy

ABSTRACT Introduction Unintended pregnancy is a risk factor for less maternal–fetal attachment (MFA) and low levels of psychological well-being. This study was conducted to determine the effect of an MFA-based training programme on maternal anxiety, depression and worries following an unintended pregnancy. Methods This randomised clinical trial was conducted on 68 women with an unintended pregnancy in north of Iran during 2018–2019. Participants were allocated to the trained and control groups through simple randomisation. The trained group received the MFA-based training for three 90-min sessions. Demographic questionnaire, London measure of unplanned pregnancy, Cranley’s MFA scale, Edinburgh postnatal depression, Spielberger anxiety and prenatal distress questionnaires were used. Data were analysed by descriptive statistics, chi square, Fisher’s exact test, independent and paired-samples t-tests, Mann–Whitney U, analysis of covariance, and multivariate analysis of variance. Results After the intervention, the mean MFA, anxiety and depression scores were not significantly different between the trained and control groups Worry was significantly decreased in the trained group (p = 0.001) and increased in the control group (p = 0.03). Discussion Although the MFA-based training could not significantly improve MFA, maternal anxiety and depression, it has been effective on worry in women with the unintended pregnancies.

IMPACT OF ULTRASOUND AND SOCIODEMOGRAPHIC VARIABLES ON MATERNAL FOETAL ATTACHMENT IN TARABA STATE, NIGERIA

Background: Maternal foetal attachment is manifested in behaviours that demonstrate care and commitment to the foetus. Ultrasound decreases maternal anxiety and confers psychological benefits following a reassuring sonogram. Maternal-foetal attachment is affected by many socio-demographic factors which include maternal age, occupation, educational level, race, marriage duration, ethnicity, Religion, income status, pregnancy planning, and identification of the foetal gender Aim: This study was aimed at assessing the effect of ultrasound and sociodemographic factors on maternal foetal attachment during pregnancy. Method: A prospective study was conducted from November 2019 to March 2020. A convenient sampling method was employed and included 404 pregnant women aged 18-45 years old in their 2nd and 3rd trimesters. The data were collected using a maternal foetal attachment scale questionnaire. Descriptive and inferential statistics were carried out at a p-value &lt; 0.05. Result: The score of the maternal foetal attachment scale was greater with post ultrasound than the pre ultrasound. There was a statistically significant difference between the pre and post ultrasound maternal foetal attachment scale (p=0.000). A statistically significant difference was observed in the maternal foetal attachment across the different ethnic groups (p=0.000), planned and unplanned pregnancy (p=0.000). Conclusion: This study revealed that ultrasound scan has an influence on maternal foetal attachment, planned pregnancy. Hausa, Bandawa and Jenjo were found to be more attached to their foetuses.

Lien prénatal et effet du vécu de la surprotection maternelle sur son développement

ObjectivesExplore the relationship between the recalled bond of pregnant women to their own mothers and the development of prenatal attachment. MethodsWomen with a single-fetal pregnancy who consulted the outpatient service of the maternity “C” ward of the center of maternity and neonatology of Tunis and had perceived fetal movements were included. Maternal-fetal attachment was assessed by the Prenatal Attachment Inventory (PAI), and the Parental Bonding Instrument (PBI) was used to evaluate experienced bond to mother. Socio demographic and clinical data were collected on a pre-established form. ResultsEighty respondents were retained from 95 recruited pregnant women. Their ages ranged from 19 to 44 with an average of 32 years. The rate of primiparity was of 28.7 % and half of pregnancies were identified at risk. The mean score of PAI was 55.3 (ET=10.79). Means scores of PBI “care” dimension and “overprotection” dimension were respectively of 26.26 (ET=5.82) and 17 (ET=6.38). The four types of maternal bonding according to the PBI scores were distributed as follow: affectionate constraint (31.3 %), affectionless control (35 %), optimal bonding (21.3 %) and weak bonding (12.5 %). The two PBI dimensions “care” and “overprotection” were significantly and negatively correlated (P<0.05). The PAI scores were not correlated with the PBI “care” dimension scores but were significantly and negatively correlated with the “overprotection” dimension scores (P<0.,01). In order to better explore this association, the “overprotection” dimension scores were studied according to the 21 items of the PAI. A negative and significant correlation was found only with three of the PAI items: item 12 (P<0;01), 15, and 20 (P<0;05). ConclusionsOur findings suggest that pregnant women whose mothers showed more overprotective and controlling behaviors could be at risk of developing a weak maternofetal attachment. Further research is needed.

Relationship of health practices with depression and maternal-fetal attachment in adolescent pregnant women: A prospective study

AimTo determine the relationship of health practices with depression and maternal-fetal attachment in adolescent pregnant women. MethodsThis prospective study was conducted on 316 adolescent pregnant women with medical records at the health centers in Tehran, Iran. The participants were selected through the complete enumeration. Data were collected using the socio-demographic and obstetrics questionnaire, the Health Practices Questionnaire-II (HPQ-II), the Edinburgh Postnatal Depression Scale (EPDS), and the Cranley's Maternal-Fetal Attachment Scale (MFAS). The data were analyzed with the Pearson correlation test, the independent t-test, one-way ANOVA, and the general linear model. ResultsThe mean scores of health practices, depression, and maternal-fetal attachment were 135.3 (SD 9.1, range 34–170), 10.1 (SD 5.4, range 0–30), and 91.6 (SD 8.6, range 24–120), respectively. The results of Pearson correlation test showed that health practices had a significant relationship with depression (r = −0.29) and maternal-fetal attachment (r = 0.37). Results of general linear model showed that an increase in the health practices score led to a significant decrease in depression score during pregnancy [β = −0.10; 95% CI: −0.17 to −0.04] and a significant increase in maternal-fetal attachment score [β = 0.30; 95% CI: 0.19 to 0.40]. ConclusionThere is significant relationship between health practices and depression, as well as maternal-fetal attachment in adolescent pregnant women. Therefore, intervention to improve one of them may improve the other one(s).

Development and application of a couple-centered antenatal education program in Korea.

PurposeThis study was conducted to develop a couple-centered antenatal education program and to test the program’s feasibility. MethodsWith a preliminary-experimental study design, 33 pregnant couples who were expecting their first child participated in this study. The program consisted of four sessions (1 hour/session/week) of education and counseling. Data were collected before and after the intervention from September 2018 to April 2019 at a women’s hospital in Daejeon, Korea, with demographic data forms, the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Maternal–Fetal Attachment Scale, Korean Newborn Care Confidence Scale, Wijma Delivery Expectancy/Experience Questionnaire, and Dyadic Adjustment Scale-10. ResultsThe pregnant women and their husbands were on average 32.30±3.10 and 33.21±6.25 years old, respectively. The mean marriage duration was 2.34±1.63 years, the gestational age was 31.30±2.66 weeks, and 78.8% of the couples had a planned pregnancy. After the program, both the pregnant women and their husbands showed significant improvements in attachment to the fetus and confidence in providing infant care. Prenatal depression, prenatal stress, and fear of childbirth in pregnant women significantly decreased after completing the program. However, the dyadic adjustment score did not change significantly either in the pregnant women or their husbands.ConclusionA couple-centered antenatal education program seems to be effective for couples adjusting to parenthood, but further studies should explore ways to have a positive impact on couples’ relationships.

Factors affecting the maternal-fetal attachment during pregnancy

Background: Maternal-fetal attachment is intangible connection and maintains a bond between mother and baby in her womb which is considered an important part of fetal development and this attachment can be affected by different factors. This study was aimed to identify the factors affecting the maternal-fetal attachment during pregnancy. Design: A descriptive design was used. Subjects: A purposive sample including 100 pregnant women were participated. Setting: Antenatal Clinics of Al-Azhar University Hospital in New Damietta City, Damietta Governorate, in Egypt. Tools: A structure Interview Questionnaire, Cranley’s Maternal-Fetal attachment Scale (CMFAS), Fetal position awareness scale (FPAS). Results: There was a positive and significant relationship between the mean of MFA in mothers with the history of fetal loss and presence of support provider and strong attachment to mother, on the other hand this study confirmed that a statistically significant negative correlation between MFA and pregnant woman's gravidity. Conclusion: Maternal fetal attachment is associated significantly and positively with multiple factors: previous fetal loss, presence of support provider, and strong attachment to mother. Education level and history of previous low birth weight baby come in the second level of significant in this study. Additionally, increased gravidity contributed to a decreased MFA level. Recommendation: Early and effective interventions should be applied for the expectant mother to achieve a physically and psychologically wellbeing during pregnancy to reach best optimize maternal and fetal health .

Does family support mediate the effect of anxiety and depression on maternal-fetal attachment in high-risk pregnant women admitted to the maternal-fetal intensive care unit?

PurposeThis study investigated the mediating effect of family support in the relationships of anxiety and depression with maternal-fetal attachment among pregnant women admitted to the maternal-fetal intensive care unit (MFICU) in Korea.MethodsThe participants were high-risk pregnant women with a gestational age of at least 20 weeks who were admitted to MFICUs in Busan and Yangsan. The Korean versions of four measurement tools were used for the self-report questionnaire: Spielberger’s State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, Cobb’s family support measurement, and Cranley’s maternal-fetal attachment scale. Data were collected from June 22 to September 20, 2020. Out of 124 participants, data from 123 respondents were analyzed. Descriptive statistics and regression analysis were done.ResultsThe average age of participants was 34.1 years. Their anxiety level was moderate (43.57±11.65 points out of 80) and 53.6% were identified as having moderate depression (average 10.13±5.48 points out of 30). Family support was somewhat high (average 43.30±5.03 points out of 55). The average score of maternal-fetal attachment was also somewhat high (73.37±12.14 points out of 96). Family support had a partial mediating effect in the relationships of anxiety and depression with maternal-fetal attachment among high-risk pregnant women admitted to the MFICU.ConclusionMaintaining family support is challenging due to the nature of the MFICU. Considering the mediating effect of family support, establishing an intervention plan to strengthen family support can be helpful as a way to improve maternal-fetal attachment for high-risk pregnant women admitted to the MFICU.

Maternal–Fetal Attachment and Domestic Violence Against Iranian and Afghan Pregnant Women: A Cross-Cultural Study

Women who have experienced more physical and psychological violence are at a higher risk of stress and depression and cannot develop a relationship with their fetuses. The present study aimed to co...

Infant sensory patterns: associations with previous perinatal loss, maternal-foetal attachment and postnatal maternal sensory patterns

PurposeThis paper aims to investigate infant sensory patterns and their associations with previous perinatal loss, maternal-foetal attachment and postnatal maternal sensory patterns.Design/methodology/approachIn a prospective cohort study, women with and without perinatal loss (N= 57) were recruited from an Australian public hospital. Participants were surveyed during pregnancy (maternal-foetal attachment, loss) and again postnatally (maternal/infant sensory patterns). Chi-square tests and logistic regression analyses controlling for previous perinatal loss were conducted with infant sensory patterns as outcome variables.Findings“More than typical” infant low registration was associated with poorer quality of maternal-foetal attachment. “More than typical” infant sensory seeking was associated with previous perinatal loss and higher levels of maternal sensory seeking. “More than typical” infant sensory sensitivity was linked with previous perinatal loss, poorer quality of maternal-foetal attachment and higher maternal low registration. “More than typical” infant sensory avoidance was associated with poorer quality of maternal-foetal attachment and higher levels of maternal sensory sensitivity.Practical implicationsTo support more typical infant sensory patterns, results point to the potential benefit of occupational therapists supporting pregnant women with previous perinatal loss; facilitating favourable maternal-foetal attachment; and educating new mothers on how their sensory patterns impact on interactions with their infant. Sensory modulation strategies that consider the sensory patterns of both mother and infant may be beneficial to promote engagement in co-occupations.Originality/valueThese findings are the first to suggest that previous perinatal loss, poorer quality of maternal-foetal attachment and higher levels of maternal postnatal sensory patterns represent risk factors for infant sensory patterns that are “more than typical.”

Mother-to-Infant Bonding is Associated with Maternal Insomnia, Snoring, Cognitive Arousal, and Infant Sleep Problems and Colic

ABSTRACT Objective Emerging evidence links maternal and infant sleep problems to impairments in the mother-to-infant bond, but the independence and directionality of these associations remain unclear. The present study characterized concurrent and prospective effects of maternal sleep disturbances and poor infant sleep on the mother-infant relationship. As common sequalae of problematic sleep, nocturnal cognitive hyperarousal and daytime sleepiness were investigated as facilitating mechanisms. Participants Sixty-seven pregnant women enrolled in a prospective study on maternal sleep. Methods Sociodemographic information and clinical symptoms were measured prenatally then weekly across the first two postpartum months. Women reported insomnia symptoms, sleep duration, snoring, daytime sleepiness, nocturnal cognitive arousal (broadly focused and perinatal-specific), perseverative thinking, depression, infant colic, infant sleep quality, and mother-infant relationship quality. Mixed effects models were conducted to test hypotheses. Results Prenatal snoring and weak maternal-fetal attachment augured poorer postpartum bonding. Poor infant sleep was associated with increased odds for maternal insomnia and short sleep. Impairments in the mother-to-infant bond were linked to maternal insomnia, nocturnal perinatal-focused rumination, daytime sleepiness, depression, and poor infant sleep. Postnatal insomnia predicted future decreases in mother-infant relationship quality, and nocturnal cognitive hyperarousal partially mediated this association. Conclusions Both maternal and infant sleep problems were associated with poorer mother-to-infant bonding, independent of the effects of maternal depression and infant colic. Perseverative thinking at night, particularly on infant-related concerns, was linked to impaired bonding, rejection and anger, and infant-focused anxiety. Improving maternal and infant sleep, and reducing maternal cognitive arousal, may improve the maternal-to-infant bond.

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.