A literature update on maternal-fetal attachment.
OBJECTIVE
To critically review and synthesize original research published since 2000 designed to measure factors that influence maternal-fetal attachment.


METHODS
EBSCOhost Research Databases that included PubMed, CINAHL Plus, PsycINFO, and SCOPUS were searched for journal articles published in the past 7 years (2000-2007) that examined variables thought to increase, decrease, or cause no change in level of maternal-fetal attachment. Keyword searches included maternal-fetal attachment, parental attachment, and prenatal attachment.


METHODS
Twenty-two studies were selected that met the inclusion criteria of original research, clear delineation of the measurement of maternal-fetal attachment, measurement of maternal-fetal attachment during pregnancy, and inclusion of women or couples, or both.


METHODS
Studies measuring maternal-fetal attachment included a broad range of variables as potential risk or protective factors, or both. Factors associated with higher levels of maternal-fetal attachment included family support, greater psychological well-being, and having an ultrasound performed. Factors such as depression, substance abuse, and higher anxiety levels were associated with lower levels of maternal-fetal attachment.


RESULTS
The large majority of studies reviewed were limited by small, homogenous samples deemed insufficient to detect significant differences, inconsistent measurement of maternal-fetal attachment during gestational periods, and cross-sectional designs.


CONCLUSIONS
Further research is essential to identify factors influencing maternal-fetal attachment. Specifically, research needs to be conducted on larger sample sizes of greater racial and ethnic diversity.
School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA. jalhuse1@son.jhmi.edu
Jeanne L
JL
Alhusen
D000022:Abortion, Spontaneous / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D003625:Data Collection; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D033261:Maternal-Fetal Relations; D009730:Nursing Assessment / Q000379:methods; D015399:Nursing Research / Q000458:organization & administration*; D009769:Object Attachment; D011247:Pregnancy / Q000523:psychology*; D011248:Pregnancy Complications / Q000523:psychology; D011272:Pregnancy, Multiple / Q000523:psychology; D036301:Qualitative Research; D027724:Reproductive Techniques, Assisted / Q000523:psychology; D012107:Research Design; D012307:Risk Factors; D018401:Sample Size; D019966:Substance-Related Disorders / Q000523:psychology; D011795:Surveys and Questionnaires