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Maternal–fetal attachment protects against postpartum anxiety: the mediating role of postpartum bonding and partnership satisfaction

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Maternal mental disorders develop frequently during the perinatal period, and can have detrimental effects on the developing bond between a mother and her child. While depression has already been widely associated with bonding disorders, the link between anxiety disorders and maternal–fetal attachment has received only limited attention. This study aimed to explore the link between maternal–fetal attachment in the third trimester and postpartum anxiety, as previous research has suggested a potentially protective association. Additionally, we hypothesized a mediating influence of postpartum bonding and partnership satisfaction as additional measurements of attachment capacity.

Methods

Self-report questionnaires assessing maternal–fetal attachment, postpartum bonding, anxiety, depression, and partnership quality were completed at three time points: third trimester (T1, N = 324), first week postpartum (T2, N = 249), and 4 months postpartum (T3, N = 166). Conditional process analyses were used to test for mediation.

Results

A statistically significant negative correlation of maternal–fetal attachment was found with maternal anxiety postpartum. Overall, the analyses supported the mediation hypothesis. There was a significant, indirect effect of maternal–fetal attachment during pregnancy on state anxiety in the first week postpartum, mediated through postpartum bonding quality and partnership satisfaction. All three variables together accounted for 18.25% (state anxiety) or 30.35% (trait anxiety) of the variance in postpartum anxiety.

Conclusions

Our results showed that a close maternal–fetal attachment buffers postpartum symptoms of anxiety, partially mediated through postpartum bonding and partnership satisfaction. Therefore, strengthening the maternal–fetal attachment and the partnership during pregnancy has the potential to reduce maternal postpartum symptoms of anxiety.

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Funding

This study was funded by the German Society of Psychosomatic Gynaecology and Obstetrics.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ruprecht-Karls-University Heidelberg, Universitätsfrauenklinik Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany

    Lina Maria Matthies, Christof Sohn, Markus Wallwiener & Stephanie Wallwiener

  2. Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, 69120, Heidelberg, Germany

    Anne Doster

  3. Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany

    Mitho Müller & Corinna Reck

Authors
  1. Lina Maria Matthies
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  2. Mitho Müller
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  3. Anne Doster
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  4. Christof Sohn
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  5. Markus Wallwiener
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  6. Corinna Reck
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  7. Stephanie Wallwiener
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Contributions

LMM: data collection and manuscript writing. MM: data collection and management, data analysis, and manuscript writing. AD: data collection and manuscript editing. MW: protocol development. CR: protocol development, data management, and manuscript editing. CS: protocol development and manuscript editing. SW: protocol development, data collection and management, data analysis, and manuscript writing.

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Correspondence to Lina Maria Matthies.

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Matthies, L.M., Müller, M., Doster, A. et al. Maternal–fetal attachment protects against postpartum anxiety: the mediating role of postpartum bonding and partnership satisfaction. Arch Gynecol Obstet 301, 107–117 (2020). https://doi.org/10.1007/s00404-019-05402-7

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