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Meta-Analysis
. 2020 Apr 12;17(8):2644.
doi: 10.3390/ijerph17082644.

Prenatal Attachment and Perinatal Depression: A Systematic Review

Luca Rollè  1 , Maura Giordano  1 , Fabrizio Santoniccolo  1 , Tommaso Trombetta  1
Affiliations
Meta-Analysis

Prenatal Attachment and Perinatal Depression: A Systematic Review

Luca Rollè et al. Int J Environ Res Public Health. .

Abstract

Pregnancy is a period of complex bio-psychological changes, during which the development of an attachment bond to the fetus takes on a central role. Depressive symptoms are common during this period. Both symptoms of depression and low levels of prenatal attachment are related to negative outcomes in caregivers and infants. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this systematic review analyzes and systematizes 41 studies concerning the association between prenatal attachment and perinatal depression. The majority of the studies reported a significant association between the two. Specifically, prenatal depressive symptoms were found to be negatively associated with prenatal attachment. Furthermore, lower levels of prenatal attachment were related to higher postnatal depressive symptoms, although fewer studies assessed this association. While these results were found across different populations, conflicting findings emerged, suggesting they should be interpreted with caution, particularly in male samples and in non-normative pregnancies (e.g., high-risk pregnancies, medically assisted pregnancies, and pregnancies with previous perinatal losses). These results are clinically important for the perinatal screening process and for implementing preventive and treatment programs. However, future studies are needed to further confirm and generalize these results.

Keywords: fathers; high-risk pregnancies; mothers; perinatal depression; postpartum; postpartum depression; pregnancy; prenatal attachment; prenatal depression; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the selection procedure adapted from the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) [82].
Figure 2
Figure 2
Graph of the number of publications in different countries.
Figure 3
Figure 3
Graph of the number of publications across time.
See this image and copyright information in PMC

References

    1. Buist A., Morse C.A., Durkin S. Men’s adjustment to fatherhood: Implications for obstetric health care. J. Obs. Gynecol. Neonatal Nurs. 2003;32:172–180. doi: 10.1177/0884217503252127. - DOI - PubMed
    1. Condon J.T., Boyce P., Corkindale C.J. The First-Time Fathers Study: A prospective study of the mental health and wellbeing of men during the transition to parenthood. Aust. N. Z. J. Psychiatry. 2004;38:56–64. doi: 10.1177/000486740403800102. - DOI - PubMed
    1. Laxton-Kane M., Slade P. The role of maternal prenatal attachment in a woman’s experience of pregnancy and implications for the process of care. J. Reprod. Infant Psychol. 2002;20:253–266. doi: 10.1080/0264683021000033174. - DOI
    1. Steen M., Downe S., Bamford N., Edozien L. Not-patient and not-visitor: A metasynthesis fathers’ encounters with pregnancy, birth and maternity care. Midwifery. 2012;28:362–371. doi: 10.1016/j.midw.2011.06.009. - DOI - PubMed
    1. Maas A.J.B.M., Vreeswijk C.M.J.M., de Cock E.S.A., Rijk C.H.A.M., van Bakel H.J.A. “Expectant Parents”: Study protocol of a longitudinal study concerning prenatal (risk) factors and postnatal infant development, parenting, and parent-infant relationships. BMC Pregnancy Childbirth. 2012;12:1–8. doi: 10.1186/1471-2393-12-46. - DOI - PMC - PubMed