The growth of maternal-fetal emotional attachment in pregnant adolescents: a prospective cohort study.
OBJECTIVE
To describe self-reported maternal-fetal emotional attachment in adolescent women over the course of pregnancy, compare it with adult pregnant women, and identify risk factors for poor attachment.


METHODS
A prospective cohort study.


METHODS
Young mothers' clinics in 2 public hospitals in metropolitan Melbourne, Australia.


METHODS
English-speaking young women aged 20 years and under attending their first antenatal visit.


METHODS
Self-report questionnaires were completed in each trimester. Validated measures were used to assess anxiety and depression symptoms and maternal-fetal emotional attachment. Data were analyzed with existing data from pregnant adults. Regression analyses were conducted to establish factors independently associated with higher mean first-trimester attachment score and lowest-quartile third trimester score adjusting for confounding variables.


METHODS
Maternal-fetal emotional attachment, assessed by the Quality and Intensity subscales and Global score on Maternal Antenatal Attachment Scale (MAAS).


RESULTS
165/194 (85%) completed the first questionnaire; 130/165 (79%) provided complete data. Mean anxiety but not depression scores were significantly higher in adolescents than adults across pregnancy. Mean (95%CI) first-trimester adolescent Global MAAS was significantly lower than adults (70.3 (68.4, 72.2) vs 76.8 (75.4, 78.2) P < .01), but there were no significant second- or third-trimester between-group differences. Adjusted odds of a lowest-quartile third-trimester MAAS score was significantly associated with lower first-trimester score (P < .001), previous abortion (P = .02) and being born overseas (P = .002).


CONCLUSIONS
Adolescents report slower development of antenatal emotional attachment than adults. Women with risk factors for poor attachment in late pregnancy are identifiable in early pregnancy and may benefit from additional multidisciplinary care.
Centre for Women's Health Gender and Society, University of Melbourne, Melbourne, Victoria, Australia; Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: heather.rowe@monash.edu.
Heather J
HJ
Rowe
Karen H
KH
Wynter
Angela
A
Steele
Jane R W
JR
Fisher
Julie A
JA
Quinlivan
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D033261:Maternal-Fetal Relations / Q000523:psychology*; D009769:Object Attachment; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011253:Pregnancy in Adolescence / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
Adolescent pregnancy; Antenatal attachment; Antenatal care; Maternal-fetal emotional attachment; Teenage pregnancy