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. 2023 Nov;27(11):2008-2016.
doi: 10.1007/s10995-023-03736-y. Epub 2023 Jun 16.

Anxiety and Depression Symptoms in At-Risk Pregnancy: Influence on Maternal-Fetal Attachment in Tunisia

Ferdaous Testouri  1 , Meriem Hamza  2   3   4 , Anissa Ben Amor  1   5 , Marwene Barhoumi  1 , Radhouane Fakhfakh  1   6   7 , Amel Triki  1   5   7 , Ahlem Belhadj  1   8
Affiliations

Anxiety and Depression Symptoms in At-Risk Pregnancy: Influence on Maternal-Fetal Attachment in Tunisia

Ferdaous Testouri et al. Matern Child Health J. 2023 Nov.

Abstract

Objectives: To investigate maternal prenatal anxiety and depression in high-risk pregnancies and examine their influence on maternal-fetal attachment.

Methods: We included 95 hospitalized high-risk pregnant women. The Hospital Anxiety and Depression Scale (HADS) and the Prenatal Attachment Inventory (PAI) were used to assess the primary objective. Internal consistency and construct validity of the PAI were investigated.

Results: The average age was 31 years and gestational age ranged from 26 to 41 weeks. Prevalence of depressive symptoms was 20% and anxiety symptoms 39%. Cronbach alpha coefficient of the PAI Tunisian version was 0.8 and the construct validity in favour of one factor model. PAI scores correlated negatively and significatively with the HADS total score (r = - 0.218, p = 0.034) and was attributed to the depression dimension only (r = - 0.205, p = 0.046).

Conclusions for practice: Emotional wellbeing of pregnant women especially in high-risk pregnancies should be explored in order to prevent consequences on women, their growing fetus, and prenatal attachment.

Keywords: Anxiety; Depression; Fetal movements; High-risk pregnancy; Prenatal attachment.

Plain language summary

What is already known? Maternal prenatal emotional well-being influences maternal–fetal attachment which has important implications on postnatal bonding. Anxiety and depression disorders during pregnancy could affect women’s attachment to their unborn child in a negative way. Research has largely been conducted with the general pregnant population with little focus on at-risk pregnancies, which are associated with increased levels of mood disorders. What this paper adds? This study highlights the impact of depression but not situational anxiety on maternal–fetal attachment in women with high-risk pregnancies, highlighting the importance of assessing and managing psychological disorders during pregnancy to enhance the quality of prenatal bonding.

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References

    1. Abasi, E., Tafazzoli, M., Esmaily, H., & Hasanabadi, H. (2013). The effect of maternal–fetal attachment education on maternal mental health. Turkish Journal of Medical Sciences, 43(5), 815–820. - DOI
    1. Alhusen, J. L., Gross, D., Hayat, M. J., Rose, L., & Sharps, P. (2012). The role of mental health on maternal-fetal attachment in low-income women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 41(6), E71-81. https://doi.org/10.1111/j.1552-6909.2012.01385.x - DOI - PubMed - PMC
    1. Alhusen, J. L., Hayat, M. J., & Gross, D. (2013). A longitudinal study of maternal attachment and infant developmental outcomes. Archives of Women’s Mental Health, 16(6), 521–529. https://doi.org/10.1007/s00737-013-0357-8 - DOI - PubMed
    1. Arafah, D., Thomas, B., Fenton, T. R., Sabr, Y., & Metcalfe, A. (2021). Validity and reliability of the Arabic version of Muller’s prenatal attachment inventory. Journal of Psychosomatic Obstetrics and Gynaecology, 42(3), 212–220. https://doi.org/10.1080/0167482x.2020.1713083 - DOI - PubMed
    1. Asplin, N., Wessel, H., Marions, L., & Georgsson Öhman, S. (2015). Maternal emotional wellbeing over time and attachment to the fetus when a malformation is detected. Sex Reprod Healthc, 6(3), 191–195. https://doi.org/10.1016/j.srhc.2015.04.003 - DOI - PubMed