The Effects of Relaxing Music on Life Distress and Maternal-fetal Attachment in Pregnant Women

Background: Although pregnancy and motherhood are enjoyable experiences, they are associated with numerous biopsychological changes requiring adaptation. The present study aimed to assess the effects of relaxing music on life distress and Maternal-Fetal Attachment (MFA) in pregnant women. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The research population included all Iranian pregnant women referring to Laleh Hospital in Tehran City, Iran, in 2020. In total, 30 women were selected using the convenience sampling method and randomly assigned into the intervention and control groups (n=15/group). The required data were collected using the Life Distress Inventory (LDI) and the Maternal-Fetal Attachment Scale (MFAS). The intervention group listened to relaxing music for twelve 45-50-minute sessions in the morning and during routine midwifery visits; however, the controls received no intervention. The collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS V. 22. Results: The obtained results indicated that the intervention group reported a lower level of life distress in the post-test, compared to the controls (P=0.0001, F=15.860). The intervention group also achieved a higher mean score on MFA, than the control group (P=0.0001, F=35.872). Conclusion: According to the present research findings, reproductive health, nursing professionals, and psychologists could recommend music as a complementary therapy to reduce stress and distress experienced by expecting mothers and to improve MFA.

Mothers' Experiences of Husband’s Involvement in Maternal Fetal Attachment: A Qualitative Study

Background: The involvement of husbands during pregnancy within the Iranian culture is one of the challenging topics. In this context, efforts to encourage male involvement in the maternal health issues can strengthen family bonds and consequently improve the relationships between men and women in societies. Objectives: This qualitative study aimed to elucidate the involvement of husbands in maternal-fetal attachment (MFA). Methods: Using a qualitative approach and conventional content analysis, 11 pregnant women referring to the health care centers in Sari, Iran were interviewed from March 2020 to February 2021. The participants met the maximum diversity criteria in terms of age, level of education, occupation, and socioeconomic status. Deep and unstructured interviews were utilized to obtain the research data. All the interviews were then transcribed verbatim and analyzed using the qualitative content analysis method developed by Graneheim and Lundman in MAXQDA Software. Results: A total of 350 codes emerged from the data. We identified a main theme entitled ‘husband support’, which included four categories and 11 sub-categories. The main categories were: (1) empathic response, (2) emotional support, (3) continued support, and (4) attention to fetus. Conclusions: Interventions to enhance husband support could increase MFA. Planning to promote male participation in pregnancy process is essential to promote maternal and child health.

Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study

Background: Pregnancy through assisted reproductive technology (ART) is a stressful experience that may affect prenatal attachment. However, maternal-fetal attachment (MFA) and anxiety in pregnancy after ART are understudied in Iran. Objective: To compare changes in MFA and pregnancy-related anxiety (PRA) in the first and third trimester of pregnancy in women who conceived through ART compared to those who conceived naturally. Materials and Methods: This longitudinal study was conducted in 2019 with 187 pregnant women (ART conception = 43, natural conception = 144). Participants were recruited using the consecutive sampling method from a prenatal clinic in Tehran. The Cranley MFA Scale and the Van Den Bergh PRA Questionnaire were used to collect the data. Results: The MFA score in the 12th wk of gestation was lower in the women who conceived with ART compared to in the women who conceived naturally, but there was no statistically significant difference between the groups in wk 36. MFA in both groups was significantly higher at gestational wk 36 than wk 12 (p ≤ 0.001). The increase in MFA score was significantly higher in the women who conceived with ART than in those who conceived naturally (p ≤ 0.001). The anxiety score declined in the two groups and no statistically significant difference was observed in the changes of anxiety scores between the two groups (p = 0.84). Conclusion: Pregnant women who conceived through ART were as attached to their fetus in the third trimester of pregnancy as other women and did not experience more PRA. Key words: Attachment, Maternal fetal relations, Assisted reproductive technology, Pregnancy, Anxiety.

Correlation of Anxiety with Pregnancy Symptoms and Maternal-fetal Attachment

Background: Anxiety during pregnancy may affect maternal-fetal attachment (MFA) and the prevalence of pregnancy symptoms. Objectives: The present study aimed to assess the correlation of anxiety with pregnancy symptoms and MFA. Methods: This cross-sectional study was conducted on 220 pregnant women in the health centers of Tabriz, Iran, in 2020. Samples were selected by the cluster sampling method. Data were collected using the socio-demographic questionnaire, Pregnancy-related Anxiety Questionnaire-revised 2 (PRAQ-R2), MFA Scale (MFAS), and Pregnancy Symptoms Inventory (PSI), all of which were completed as self-administered in the second half of pregnancy. The Pearson’s correlation coefficient and adjusted general linear model were used for data analysis. Results: The results of Pearson’s correlation showed no correlation between anxiety during pregnancy and MFA among nulliparous (r = -0.003, P = 0.976) and multiparous (r = -0.003, P = 0.712) pregnant women. However, anxiety and pregnancy symptoms were significantly correlated among nulliparous (r = 0.424, P < 0.001) and multiparous (r = 0.227, P = 0.028) pregnant women. According to the general linear model, after adjusting the socio-demographic variables, a significant correlation was observed between anxiety and pregnancy symptoms (P < 0.001), while no relationship was found between anxiety and MFA (P = 0.705). Conclusions: Given the significant correlation between anxiety and pregnancy symptoms, pregnant women with anxiety symptoms need to be screened and treated by an expert psychological team if their disorder is confirmed.

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.

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 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 < 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.

Does Interactive Ultrasound Intervention Relieve Minor Depressive Symptoms in Pregnancy? A Randomized Controlled Trial

BackgroundPerinatal depression, especially minor depression, is common during pregnancy and is likely to continue into the postpartum period. It impairs the mother’s health, infant’s neurodevelopment, and the mother-infant relationship. Screening for perinatal depression is recommended; however, there is no uniform alignment of how to treat depressive symptoms while simultaneously supporting the mother-infant relationship. Ultrasound screenings might be potential as an intervention method because it has shown to improve maternal-fetal attachment among pregnant women. Our aim is to develop a 4 dimensional-based (4D) interactive ultrasound intervention and test whether it relieves minor depressive symptoms and improves maternal-fetal attachment. Previous studies show that supporting the mother-infant relationship aids in relieving maternal depression. Until now, few studies have combined pregnancy ultrasound and psychological support. MethodsA controlled randomized setting was designed to assess whether interactive 4D-ultrasound intervention would decrease maternal depressive symptoms, strengthen maternal-fetal attachment, and mother-infant relationship. A sonographer and a psychologist specialized in infant mental health conduct the interventions. The focus of the session is to jointly observe the behavior of the fetus according to the mothers’ wishes. Altogether, 100 women scoring 10-15 in Edinburgh Pre/-Postnatal Depression Scale (EPDS) and with singleton pregnancy will be recruited using a web-based questionnaire. Half of the participants will be randomized to the intervention group and will receive three interactive ultrasound examinations. The primary outcome is the change in the mean EPDS score. EPDS measurements will be done at three time points: before and after the intervention and four to five months after delivery. The secondary outcomes are maternal representations that will be assessed using the Working Model of the Child Interview (WMCI) and prenatal attachment that will be assessed using the Maternal Antenatal Attachment Scale (MAAS) questionnaire. The postnatal mother-infant interaction will be assessed with the Parent-Child Early Relational Assessment (PCERA) and Maternal Postnatal Attachment Scale (MPAS). DiscussionUltrasound is widely used during pregnancy. The interactive approach is unique and it would be feasible as part of routine screenings and maternity clinic visits. Intervention decreasing depression and simultaneously supporting maternal-fetal attachment could be a valuable addition in treating minor depression among pregnant women. Trial registrationRegistered on January 5th 2018, ClinicalTrials.gov NCT03424642. https://clinicaltrials.gov/ct2/show/NCT03424642