BACKGROUND: Maternal-fetal attachment might be associated with maternal mental health issues, but previous results have been inconsistent, particularly regarding prenatal anxiety. We compared maternal-fetal attachment between pregnant women with and without symptoms of antenatal depression and anxiety. Additionally, we examined the relationships between prenatal depressive and anxiety symptoms, psychosocial stress, and maternal-fetal attachment. METHODS: We conducted a cross-sectional study involving a sample of 2,233 pregnant women. The data were collected between March 2021 and March 2023 at outpatient clinics in the Czech Republic. We used self-report questionnaires to assess symptoms of prenatal depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety (Perinatal Anxiety Screening Scale, PASS), psychosocial stress (Prenatal Psychosocial Profile, PPP), and maternal-fetal attachment (Prenatal Attachment Inventory - Revised, PAI-R). RESULTS: Women without symptoms of antenatal depression had higher total scores on the PAI-R (U = 336,357; p = .013) and on the PAI-R Interaction subscale (U = 322,913; p < .001), suggesting a higher quality of maternal-fetal attachment than women with symptoms. No other significant associations were found between antenatal depression, anxiety and the PAI-R subscales scores. CONCLUSIONS: Our results suggest that women experiencing increased depressive, but not anxiety, symptoms in pregnancy, have a poorer quality of attachment to their child, although the effect size is small. Consequently, treating prenatal depression in women could have a positive effect on maternal-fetal attachment.

2nd Faculty of Medicine Charles University Prague Czech Republic

3rd Faculty of Medicine Charles University Prague Czech Republic

Faculty of Arts Department of Psychology Charles University Prague Czech Republic

Faculty of Science Department of Demography and Geodemography Charles University Prague Czech Republic

National Institute of Mental Health Klecany Czech Republic

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