Maternal-antenatal attachment is higher in young pregnant women with more social support, mentors, and lower fear of childbirth

The goal of this study was to examine correlates of maternal-fetal attachment in a diverse sample of young pregnant mothers. Although studies have looked at social determinants of health and maternal-fetal attachment, none have examined correlates that may be more prevalent in younger populations including prenatal drug use or fear of childbirth. We analyzed data from a prospective cohort of 154 pregnant adolescents and young adults (75.5% Black/African American, 15.6% white, 7.5% biracial, 1.4% other) ranging from 14-21 years old. Participants were recruited early in pregnancy and completed online surveys during each trimester of pregnancy. Maternal fetal attachment was measured with the Maternal Antenatal Attachment Scale (MAAS) between 30-36 weeks gestation. A linear regression model was constructed to determine the independent contributions of demographic variables (age, race, sexual minority status), maternal mental health, substance use, and social support to maternal-fetal attachment. Third trimester social support, presence of a natural mentor, not having a younger partner, and lower fear of childbirth were associated with higher MAAS scores, and therefore greater maternal fetal attachment, accounting for 32% of the variance in MAAS scores. Maternal age, substance use, and psychological symptoms were not significantly related to maternal fetal attachment in this sample. Social support and patient education to lessen fear of childbirth should be the target of interventions to improve maternal-fetal attachment in adolescent and young adult women. Fostering and supporting mentorship may also be a promising avenue to improve maternal-fetal bonding in younger patients. More research is needed to better understand the impact of perceived health, body dissatisfaction, physical fitness, healthcare access, pre-existing OB/GYN conditions, fear of breastfeeding, history of emotional neglect, and future child rearing support to address gaps in knowledge within this field.