Archives of Gynecology and Obstetrics

, Volume 286, Issue 2, pp 309–316

The association of prenatal attachment and perinatal factors with pre- and postpartum depression in first-time mothers

  • T. W. Goecke
  • F. Voigt
  • F. Faschingbauer
  • G. Spangler
  • M. W. Beckmann
  • A. Beetz
Maternal-Fetal Medicine



This prospective study investigated associations between prenatal attachment of adult first-time mothers to the unborn child, perinatal factors and levels of depression before and up to 18 months after delivery.


Primiparas (N = 161) without specific risk factors answered the following questionnaires during the last term of pregnancy (t1): Edinburgh Postnatal Depression Scale (EPDS), Maternal Antenatal Attachment Scale (MAAS), questionnaire on the schema of the unborn child, and a questionnaire about the pregnancy. Perinatal data were taken from the patients’ files. The EPDS was answered 3 weeks (t2, N = 157), 6 months (t3, N = 159), and 18 months (t4, N = 132) postpartum.


During pregnancy, 16.9 % of the women indicated mild depressive symptoms, and 7.5 %, medium to severe symptoms of depression. Mild symptoms of depression were found in 25.5 % at t2, 10.1 % at t3, and 12.2 % at t4; medium to severe symptoms were reported by 7.6, 1.9 and 5.6 %, respectively. Women with low control during delivery (emergency Caesarean) showed a tendency for higher levels (p = 0.067) of depression at t3 than women with elective Caesarean did. The quality of prenatal attachment to the unborn child correlated negatively with depressive symptoms at t1–t4.


The closer the prenatal attachment of a mother to her unborn child, the less symptoms of depression she reports during the last term of pregnancy and postpartum. Therefore, promoting good mother–child attachment during pregnancy might influence the level of postpartum depression.


Prenatal attachment Postpartum depression Prenatal depression Mode of delivery Perinatal injuries Mother–child bond 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • T. W. Goecke
    • 1
  • F. Voigt
    • 1
  • F. Faschingbauer
    • 1
  • G. Spangler
    • 2
  • M. W. Beckmann
    • 1
  • A. Beetz
    • 2
    • 3
  1. 1.Department of Obstetrics and GynecologyUniversity of ErlangenErlangenGermany
  2. 2.Department of PsychologyUniversity of Erlangen-NuermbergErlangenGermany
  3. 3.Institute for Special Education and Development and Rehabilitation, University of RostockRostockGermany

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