Volume 19, Issue 12 (December 2021)                   IJRM 2021, 19(12): 1075-1084 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ranjar F, Warmelink J, Mousavi R, Gharacheh M. Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study. IJRM 2021; 19 (12) :1075-1084
URL: http://ijrm.ir/article-1-2030-en.html
1- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Midwifery Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands. Department of General Practice and Elderly Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. Midwifery Academy, Academie Verloskunde Amsterdam Groningen (AVAG), the Netherlands.
3- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
4- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. , gharacheh.m@gmail.com
Abstract:   (1325 Views)
Background: Pregnancy through assisted reproductive technology (ART) is a stressful experience that may affect prenatal attachment. However, maternal-fetal attachment (MFA) and anxiety in pregnancy after ART are understudied in Iran.
Objective: To compare changes in MFA and pregnancy-related anxiety (PRA) in the first and third trimester of pregnancy in women who conceived through ART compared to those who conceived naturally.
Materials and Methods: This longitudinal study was conducted in 2019 with 187 pregnant women (ART conception = 43, natural conception = 144). Participants were recruited using the consecutive sampling method from a prenatal clinic in Tehran. The Cranley MFA Scale and the Van Den Bergh PRA Questionnaire were used to collect the data.
Results: The MFA score in the 12th wk of gestation was lower in the women who conceived with ART compared to in the women who conceived naturally, but there were no statistically significant difference between the groups in wk 36. MFA in both groups was significantly higher at gestational wk 36 than wk 12 (p ≤ 0.001). The increase in MFA score was significantly higher in the women who conceived with ART than in those who conceived naturally (p ≤ 0.001). The anxiety score declined in the two groups and no statistically significant difference was observed in the changes of anxiety scores between the two groups (p = 0.84).
Conclusion: Pregnant women who conceived through ART were as attached to their fetus in the third trimester of pregnancy as other women and did not experience more PRA.
Full-Text [PDF 284 kb]   (824 Downloads) |   |   Full-Text (HTML)  (330 Views)  
Type of Study: Original Article | Subject: Pregnancy Health

1. Yoshimasu K, Sato A, Miyauchi N, Tsuno K, Nishigori H, Nakai K, et al. Lack of association between receiving ART treatment and parental psychological distress during pregnancy: Preliminary findings of the Japan environment and children's study. Reprod Biomed Soc Online 2018; 5: 5-16. [DOI:10.1016/j.rbms.2017.09.002] [PMID] [PMCID]
2. Boz İ, Özçetin E, Teskereci G. Becoming a mother after infertility: A theoretical analysis. Curr Approach Psychiatr 2018; 10: 496-511. [DOI:10.18863/pgy.382342]
3. Pandey Sh, Shetty A, Hamilton M, Bhattacharya S, Maheshwari A. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: A systematic review and meta-analysis. Hum Reprod Update 2012; 18: 485-503. [DOI:10.1093/humupd/dms018] [PMID]
4. Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaat FW, Braat DDM. Women's emotional adjustment to IVF: A systematic review of 25 years of research. Hum Reprod Update 2007; 13: 27-36. [DOI:10.1093/humupd/dml040] [PMID]
5. Hammarberg K, Fisher JRW, Wynter KH. Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: A systematic review. Hum Reprod Update 2008; 14: 395-414. [DOI:10.1093/humupd/dmn030] [PMID]
6. McMahon CA, Boivin J, Gibson FL, Hammarberg K, Wynter K, Saunders D, et al. Pregnancy-specific anxiety, ART conception and infant temperament at 4 months post-partum. Hum Reprod 2013; 28: 997-1005. [DOI:10.1093/humrep/det029] [PMID]
7. Ranjbar F, Warmelink JC, Gharacheh M. Prenatal attachment in pregnancy following assisted reproductive technology: A literature review. J Reprod Infant Psychol 2020; 38: 86-108. [DOI:10.1080/02646838.2019.1705261] [PMID]
8. Pisoni C, Garofoli F, Tzialla C, Orcesi S, Spinillo A, Politi P, et al. Risk and protective factors in maternal-fetal attachment development. Early Hum Dev 2014; 90 (Suppl.): S45-S46. [DOI:10.1016/S0378-3782(14)50012-6]
9. Lawson KL, Turriff-Jonasson ShI. Maternal serum screening and psychosocial attachment to pregnancy. J Psychosom Res 2006; 60: 371-378. [DOI:10.1016/j.jpsychores.2006.01.010] [PMID]
10. Tichelman E, Westerneng M, Witteveen AB, van Baar AL, van der Horst HE, de Jonge A, et al. Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review. PloS One 2019; 14: e0222998. [DOI:10.1371/journal.pone.0222998] [PMID] [PMCID]
11. Gourounti K. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women Health 2016; 56: 98-118. [DOI:10.1080/03630242.2015.1074642] [PMID]
12. Hashemieh Ch, Neisani Samani L, Taghinejad H. Assessment of anxiety in pregnancy following assisted reproductive technology (ART) and associated infertility factors in women commencing treatment. Iran Red Crescent Med J 2013; 15: e14465. [DOI:10.5812/ircmj.14465] [PMID] [PMCID]
13. Inhorn MC, Birenbaum-Carmeli D, Tremayne S, Gürtin ZB. Assisted reproduction and Middle East kinship: A regional and religious comparison. Reprod Biomed Soc Online 2017; 4: 41-51. [DOI:10.1016/j.rbms.2017.06.003] [PMID] [PMCID]
14. Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res 1981; 30: 281-284. [DOI:10.1097/00006199-198109000-00008] [PMID]
15. Jamshidimanesh M, Astaraki L, Moghadam ZB, Taghizadeh Z, Haghani H. [Maternal-fetal attachment and its associated factors]. Hayat 2013; 18: 33-45. (in Persian)
16. Van den Bergh B. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. J Prenat Perinat Psychol Health 1990; 5: 119-130.
17. Askarizadeh G, Karamoozian M, Darekordi A. Validation of Iranian version of pregnancy related anxiety questionnaire. Int J Prevent Med 2017; 8: 17. [DOI:10.4103/ijpvm.IJPVM_63_16] [PMID] [PMCID]
18. Rowe H, Fisher J, Quinlivan J. Women who are well informed about prenatal genetic screening delay emotional attachment to their fetus. J Psychosom Obstet Gynecol 2009; 30: 34-41. [DOI:10.1080/01674820802292130] [PMID]
19. Udry‐Jørgensen L, Darwiche J, Germond M, Wunder D, Vial Y. Anxiety, depression, and attachment before and after the first‐trimester screening for Down syndrome: Comparing couples who undergo ART with those who conceive spontaneously. Prenatal Diagn 2015; 35: 1287-1293. [DOI:10.1002/pd.4688] [PMID]
20. Smorti M, Smorti A. Medical successes and couples' psychological problems in assisted reproduction treatment: A narrative based medicine approach. J Matern Fetal Neonatal Med 2013; 26: 169-172. [DOI:10.3109/14767058.2012.722728] [PMID]
21. Lin YN, Tsai YC, Lai PH. The experience of Taiwanese women achieving post-infertility pregnancy through assisted reproductive treatment. Family J 2013; 21: 189-197. [DOI:10.1177/1066480712466827]
22. Hjelmstedt A, Widström AM, Wramsby H, Collins A. Emotional adaptation following successful in vitro fertilization. Fertil Steril 2004; 81: 1254-1264. [DOI:10.1016/j.fertnstert.2003.09.061] [PMID]
23. Allot L, Payne D, Dann L. Midwifery and assisted reproductive technologies. N Z College Midwives J 2013; 47: 10-14. [DOI:10.12784/nzcomjnl47.2013.2.10-13]
24. Velikonja VG, Lozej T, Leban G, Verdenik I, Bokal EV. The quality of life in pregnant women conceiving through in vitro fertilization. Zdr Varst 2016; 55: 1-10. [DOI:10.1515/sjph-2016-0001] [PMID] [PMCID]
25. Ranjbar F, Gharacheh M. Increased rate of elective cesarean delivery following assisted reproductive technology: A letter to the editor. Int J Reprod BioMed 2020; 18: 145-146. [DOI:10.18502/ijrm.v18i2.6425] [PMID] [PMCID]
26. Fisher JRW, Hammarberg K, Baker GHW. Antenatal mood and fetal attachment after assisted conception. Fertil Steril 2008; 89: 1103-1112. [DOI:10.1016/j.fertnstert.2007.05.022] [PMID]
27. Brandon AR, Pitts S, Denton WH, Stringer CA, Evans H. A history of the theory of prenatal attachment. J Prenat Perinat Psychol Health 2009; 23: 201-222.
28. Kuo PCh, Bowers B, Chen YCh, Chen ChH, Tzeng YL, Lee MS. Maternal-foetal attachment during early pregnancy in Taiwanese women pregnant by in vitro fertilization. J Adv Nurs 2013; 69: 2502-2513. [DOI:10.1111/jan.12135] [PMID]
29. Rubin R. Maternal tasks in pregnancy. J Adv Nurs 1976; 1: 367-376. [DOI:10.1111/j.1365-2648.1976.tb00921.x] [PMID]
30. Klossner J. Introductory maternity & pediatric nursing. Philadelphia: Lippincott Williams & Wilkins Publications; 2006.
31. Velez MP, Hamel C, Hutton B, Gaudet L, Walker M, Thuku M, et al. Care plans for women pregnant using assisted reproductive technologies: A systematic review. Reprod Health 2019; 16: 9. [DOI:10.1186/s12978-019-0667-z] [PMID] [PMCID]
32. Huizink A, Menting B, Oosterman M, Verhage M, Kunseler F, Schuengel C. The interrelationship between pregnancy-specific anxiety and general anxiety across pregnancy: A longitudinal study. J Psychosom Obstet Gynecol 2014; 35: 92-100. [DOI:10.3109/0167482X.2014.944498] [PMID]
33. Darwiche J, Lawrence C, Vial Y, Wunder D, Stiefel F, Germond M, et al. Anxiety and psychological stress before prenatal screening in first-time mothers who conceived through IVF/ICSI or spontaneously. Women Health 2014; 54: 474-485. [DOI:10.1080/03630242.2014.897677] [PMID]
34. Pellerone M, Miccichè S. Prenatal attachment and anxiety: Women who decide to try in vitro fertilization and women who procreate naturally. Psychol Res 2014; 4: 419-427. [DOI:10.17265/2159-5542/2014.06.002]
35. McMahon C, Boivin J, Gibson F, Hammarberg K, Wynter K, Saunders D, et al. Age at first birth, mode of conception and psychological wellbeing in pregnancy: Findings from the parental age and transition to parenthood Australia (PATPA) study. Hum Reprod 2011; 26: 1389-1398. [DOI:10.1093/humrep/der076] [PMID]
36. Stevenson EL, Trotter KJ, Bergh C, Sloane R. Pregnancy-related anxiety in women who conceive via in vitro fertilization: A mixed methods approach. J Perinat Educ 2016; 25: 193-200. [DOI:10.1891/1058-1243.25.3.193] [PMID] [PMCID]
37. McNamara J, Townsend ML, Herbert JS. A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PloS One 2019; 14: e0220032. [DOI:10.1371/journal.pone.0220032] [PMID] [PMCID]
38. Lindgren K. Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Res Nurs Health 2001; 24: 203-217. [DOI:10.1002/nur.1023] [PMID]

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb