History of perinatal loss and maternal-fetal attachment behaviors

Women Birth. 2013 Sep;26(3):185-9. doi: 10.1016/j.wombi.2013.04.005. Epub 2013 May 28.


Background: Maternal-fetal attachment (MFA) is an important requirement for optimal maternal-infant adaptation. Current studies showed conflicting findings about whether a history of perinatal loss (fetal/neonatal death) affects maternal attachment in pregnancy.

Research question: "Does a history of perinatal loss affect maternal-fetal attachment behaviors?"

Methods: One hundred women with and without a history of PL were recruited using a convenience method of sampling, from prenatal care services affiliated to Shahid Behesti University of Medical Sciences. Data collected by questionnaires from a convenience sample of multiparous women in the 3rd trimester of pregnancy with no surviving children were compared with data from a selected cohort of primigravid women. The two groups of women were matched for health and literacy. The data collected included demographic characteristics and responses to 24 questions in five groups of behaviors on the Persian version of Cranly's Maternal-Fetal Attachment Scale. Data were analyzed by SPSS 13 and using t, ANOVA, Chi square, Pearson correlation and Mann-Whitney tests.

Findings: Finding showed that total score of MFA for women with a history of PL (68.95±9.20%) is not significantly different from this score for women without such a history (71.22±11.75%; p<0.05). Women with a history of PL had a significantly lower score for a subgroup of behaviors "differentiation of self from fetus" compared to women without of a history of PL (78.25 vs. 83.21%; p<0.05). But, there were no statistically significant differences between two groups respecting to other subgroups of behaviors between two groups.

Conclusion: In this study, a history of pregnancy loss was found to be associated with disturbances in the group of maternal-fetal attachment behaviors related to "differentiation of self from fetus" in a subsequent pregnancy.

Keywords: Maternal Health; Maternal–fetal attachment; Perinatal care; Perinatal loss; Pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fetal Death*
  • Humans
  • Iran / epidemiology
  • Maternal Behavior*
  • Maternal-Fetal Relations / psychology*
  • Mother-Child Relations*
  • Object Attachment*
  • Perinatal Mortality*
  • Pregnancy
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult