Which social, gestational and mental health aspects are associated to maternal-fetal attachment? / Quais aspectos sociais, gestacionais e de saúde mental materna estão associados ao apego materno-fetal?

Abstract Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women. Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors. Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]). Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p<0,20 foram levadas para análise multivariada, por meio de regressão linear, a fim de controlar possíveis fatores de confusão. Resultados: foram incluídas 840 gestantes. As gestantes que apresentaram menores médias de AMF foram aquelas que não moravam com um companheiro (B=-3,8 [IC95%=-6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC95%=-5,9; -2,6]), que não tiveram o apoio da mãe durante a gestação (B=-2,4 [IC95%=-4,6; -0,2]) e que apresentaram sintomas depressivos (B=-4,9 [IC95%=-7,4; -2,5]). Conclusões: os resultados mostraram que um maior AMF está associado a presença de uma rede de apoio adequada na gravidez, melhor saúde mental materna e a uma gestação avançada. A avaliação precoce do AMF e a promoção de um vínculo pré-natal adequado, com foco nos aspectos psicológicos e emocionais maternos são fortemente sugeridos.

Apego materno-fetal e transtornos psiquiátricos em gestantes com fetos malformados / Maternal-fetal attachment and psychiatric disorders in pregnant women with malformed fetuses

OBJETIVO: Determinar a prevalência e os fatores associados aos sintomas de ansiedade e depressão e ao apego materno-fetal em gestantes com diagnóstico de malformações congênitas. MÉTODOS: Estudo prospectivo de corte transversal realizado durante o período de dezembro/2019 a março/2020. Foram incluídas 77 gestantes com diagnóstico de malformação fetal atendidas no Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) e excluídas aquelas < 18 anos e as que sabiam o diagnóstico da malformação há menos de três semanas. Aplicou-se um questionário com variáveis sociodemográficas e clínicas, além da Escala Hospitalar de Ansiedade e Depressão e da Escala de Apego Materno-Fetal. Para análise estatística, foi aplicado o modelo de regressão logística multivariado com nível de significância de 5%. RESULTADOS: Entre as gestantes, 46,8% possuíam sintomas ansiosos e 39%, depressivos, sendo o apego materno-fetal médio em 54,5% e alto em 45,5%. Antecedentes de ansiedade e depressão e não possuir religião foram associados a maior risco de sintomas de ansiedade e depressão, e saber da malformação há ≥ 10 semanas associou-se apenas ao risco de ansiedade e ter gestação múltipla associou-se apenas ao risco de depressão. O apego materno-fetal não foi associado a ansiedade ou depressão. CONCLUSÃO: Observou-se alta prevalência de sintomas ansiosos e depressivos em gestantes com fetos malformados, além da presença de apego materno-fetal médio/alto em todas pacientes, porém sem associação com os transtornos psiquiátricos estudados. Diante disso, urge a necessidade da criação de novas linhas de cuidado voltadas à saúde mental dessas mulheres.

OBJECTIVE: To determine the prevalence and factors associated with anxiety and depression symptoms and maternal-fetal attachment in pregnant women diagnosed with congenital malformations. METHODS: Prospective cross-sectional study conducted from December/2019 to March/2020. Seventy-seven managers with a diagnosis of fetal malformation attended at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) and those under 18 years of age who did not know the diagnosis of malformation in less than 3 weeks were excluded. Applicable to a questionnaire with clinical and sociodemographic variables, in addition to the Hospital Anxiety and Depression Scale and Maternal- -Fetal Attachment Scale. For statistical analysis, the multivariate logistic regression model was applied with a 5% significance level. RESULTS: Among pregnant women, 46.8% had anxiety symptoms and 39% depressive symptoms, with average maternal-fetal attachment at 54.5% and high at 45.5%. History of anxiety and depression and cannot use religion have been associated with an increased risk of anxiety and depression, whereas malformation saber for ≥ 10 weeks, associated only with risk of anxiety and multiple pregnancy only in depression. Maternal-fetal attachment was not associated with anxiety or depression. CONCLUSION: If there is a high prevalence of anxious and depressive symptoms in pregnant women with malformed fetuses, in addition to the presence of medium maternal-fetal/high attachment in all patients, with no association with the studied psychiatric disorders. Therefore, request the creation of new lines of care aimed at the mental health of these women.

Moderating Effect of Perceived Social Support on Relationship Between Negative Emotion and Maternal-Fetal Attachment / 中国实用护理杂志

Objective@#To explore the effect of anxiety, depression, perceived social support on maternal-fetal attachment (MFA) in women during late pregnancy.@*Method@#A sample of 207 cases of women during late pregnancy was assessed with Maternal Antenatal Attachment Scale, Perceived Social Support Scale and Hospital Anxiety and Depression Scale.@*Results@#Anxiety and depression scores were negatively correlated with MFA scores (r=-0.401,-0.416, P<0.01); perceived social support scores were negatively correlated with anxiety and depression (r=-0.233,-0.362, P<0.01), but positively correlated with MFA scores (r=0.200, P<0.01). The interactive effects of anxiety×perceived social support and depression × perceived social support on MFA were significant(β=0.196、0.204, P<0.01).@*Conclusion@#Perceived social support played a moderating role between negative emotion and MFA.

Moderating Effect of Perceived Social Support on Relationship Between Negative Emotion and Maternal-Fetal Attachment / 中国实用护理杂志

Objective To explore the effect of anxiety, depression, perceived social support on maternal-fetal attachment (MFA) in women during late pregnancy. Method A sample of 207 cases of women during late pregnancy was assessed with Maternal Antenatal Attachment Scale, Perceived Social Support Scale and Hospital Anxiety and Depression Scale. Results Anxiety and depression scores were negatively correlated with MFA scores (r=-0.401,-0.416, P<0.01); perceived social support scores were negatively correlated with anxiety and depression (r=-0.233,-0.362, P<0.01), but positively correlated with MFA scores (r=0.200, P<0.01). The interactive effects of anxiety×perceived social support and depression×perceived social support on MFA were significant(β=0.196、0.204, P<0.01). Conclusion Perceived social support played a moderating role between negative emotion and MFA.

A Comparative Study of Anxiety, Pain and Maternal-fetal Attachment between Women who became Pregnant after Infertility Treatment and became Pregnant Naturally

PURPOSE: This study was a comparative study to understand the levels of anxiety, pain and maternal-fetal attachment between women who became pregnant after infertility treatment and became pregnant naturally. METHODS: This study used a comparative survey design. Data were collected by 50 couples of natural pregnancy and of who became pregnant after infertility treatment who visited delivery room in C Medical hospital, Seoul. These couples were to have first baby, and cervix dilatation of women was less than 3 cm regardless of diagnosis. RESULTS: The score of anxiety of infertile women was significantly higher than that of naturally pregnant women; however, that of spouses showed no difference. The pain score for infertile women was significantly higher in both the active and transition phases. Pain scores that reported by their spouses did not show differences in either phase. The score of maternal-fetal attachment showed no difference between two groups of women. CONCLUSION: The result showed the importance of nursing intervention to reduce women's anxiety and pain, through both antenatal-childbirth education programs and assertive nursing interventions. It is necessary to develop and evaluate new intervention which would be more effective for reducing pain and anxiety for couples who became pregnant after infertility treatment.

Relationship Between Maternal Fetal Attachment and State Anxiety of Pregnant Women in the Preterm Labor

PURPOSE: The Purpose of this study was to investigate relationships between maternal fetal attachment and state anxiety for pregnant women in preterm labor. METHODS: The subjects consisted of 56 pregnant women in preterm labor on C hospital. The data were analyzed using SPSS computer program that includes descriptive statistics, mean, standard deviation, t-test, ANOVA, Scheffe? test and Pearson correlation coefficient. RESULTS: Age distribution was 30~39 years of age. Mean score of maternal fetal attachment was 91.50. The group whose planned pregnancy was highest showed higher maternal fetal attachment. The primigravida group showed high maternal fetal attachment. Most frequently practiced attachment item was: "I'm really looking forward to seeing what the baby looks like". The next was was: "I enjoy watching my tummy jiggle as the baby kicks inside". There was no difference in degree of anxiety by general and obstetrical characteristics. There was statistically significant of negative correlation between maternal fetal attachment and state anxiety for pregnant women with preterm labor. CONCLUSION: Findings provide useful information for further studies in reducing anxiety and intervention programs relating to pregnancy and preterm labor. To increase maternal fetal attachment of pregnant women with preterm labor, it is necessary to standardize prenatal education program.

Relações entre a saúde mental da gestante e o apego materno-fetal / Relations between pregnant women's mental health and maternal-fetal attachment

O estudo investigou as relações entre variáveis sociodemográficas, saúde mental da gestante e o apego materno-fetal no terceiro trimestre de gestação. Participaram do estudo 261 gestantes selecionadas através de amostragem por acessibilidade em quatro maternidades públicas. As gestantes responderam individualmente uma ficha de dados sociodemográficos, a Escala de Apego Materno-Fetal e o SRQ-20. A análise de regressão revelou que o número de filhos (4%) e a saúde mental materna (4,2%) explicaram parte da variância no apego materno-fetal. A escolaridade da mãe e do pai não esteve associada a essa variável. O modelo de regressão múltipla considerando os quatro fatores analisados, explicou 8,2% da variância nos escores de apego materno-fetal. Discutem-se as implicações dessas variáveis na formação do vínculo da mãe com o bebê durante a gestação.

This study investigated the relations among sociodemographic variables, pregnant women mental health, and maternal-fetal attachment in the third trimester of pregnancy. Participants were 261 pregnant women recruited from public maternity wards using a convenience sampling technique. Each pregnant woman completed a sociodemographic data form, the Maternal-Fetal Attachment Scale, and the SRQ-20. Regression analysis revealed that the number of children (4%) and mothers' mental health (4.2%) accounted for part of the variance in maternal-fetal attachment scores. Father's and mother's schooling was not associated with this variable. Taking the four analyzed factors into account, a multiple regression model accounted for 8.2% of the variance in the maternal-fetal attachment scores. The implications of these variables for mother-infant bonding during pregnancy are discussed.

A Study on the Relationship Between State Anxiety and Maternal Fetal Attachment of Unmarried Mothers in a Welfare Center / 여성건강간호학회지

PURPOSE: The Purpose of this study was to investigate the relationship between state anxiety and maternal fetal attachment of unmarried mothers in a welfare center. METHODS: The subjects were 25 unmarried mothers in a welfare center. The data was collected through personal interviews using a questionnaire. The instruments used for this study were the modified Spielberger's state anxiety inventory and Cranley's Maternal-Fetal Attachment Scale. Data was analyzed descriptive statistics, mean, standard deviation, t-test and the pearson correlation coefficient with the SPSS computer program. RESULTS: The age of the subjects ranged from 15 to 25, and their average age was 20.0. The mean score of state anxiety was 58.2. There was significant difference in the degree of maternal state anxiety between the group whose pregnancy was known by their family and the group whose pregnancy was hidden. The group whose pregnancy was known showed a low state anxiety score. There was a significant difference in the degree of maternal state anxiety by the gestational period. The group who were in the second and third gestational trimester showed lower state anxiety score than in the first trimester. The mean score of maternal-fetal attachment (MFA) was 64.9. There were significant differences in the degree of maternal fetal attachment, by an ultrasound scan experience. The most frequently practiced attachment item was "I think the fetus is able to feel (mean 3.8) ". Unmarried mothers degree of state anxiety showed a negative correlation with the degree of maternal fetal attachment (r=-.25), but there was no significant difference between the two variables. CONCLUSIONS: The unmarried mothers made an effort in striving to reduce their high state anxiety and to enhance maternal fetal attachment. They also realize how to take care of their state anxiety.

Differences of Maternal Fetal Attachment between the Rooming-in and Non-rooming in Groups of Postpartum Women / 간호학회지

PURPOSE: The purpose of this study was to identify whether the maternal-fetal attachment is related to choose the rooming-in of postpartum women. METHOD: This is a retrospective descriptive study. The data was collected from April 1 to May 31, 2001. Subjects who had NSVD were 68 mothers who opted the rooming-in and 98 mothers who did not choose the rooming-in at one hospital in Seoul, Korea. The research questionnaire consisted of 14 items on general characteristics, and 24 items on maternal fetal attachment developed by Cranley(1981). RESULT: 1. There was significant statistical difference in general characteristics between rooming-in and non rooming-in groups in prenatal class attendance, and husband attendance during the delivery. 2. There was significantly higher level of maternal fetal attachment score in the rooming-in group. 3. There was higher level of maternal fetal attachment score in the group which had participated in childbirth education than the group which didn't had participated. CONCLUSION: It could be concluded that the maternal fetal attachment is identified as a significant factor choosing the rooming in for postpartum women. Therefore it is needed to increase maternal fetal attachment of pregnant women before making decision for whether they choose the rooming-in or non-rooming in after delivery.