Exploring the impact of antenatal stress on maternal-fetal attachment in high-risk pregnancies: an explanatory...

The negative effects of perceived stress during pregnancy on mother-infant attachment and fetal health are well known. However, studies that comprehensively investigate this relationship using both quantitative and qualitative data, particularly in high-risk pregnancies, are limited. The aim of the study is to investigate the effects of perceived stress on the antenatal and fetal health in high-risk pregnancies.

The study is designed as a sequential explanatory mixed-methods approach consisting of quantitative and qualitative stages. Pregnant women were selected from those who visited the hospital's maternity clinic using convenience sampling. The study was conducted between January 2024 and December 2024. In the first stage, quantitative data were collected using a descriptive information form, the Fetal Attachment Inventory (FAI), the Antenatal Perceived Stress Inventory (APSI), and a semi-structured interview form. In the second stage, open-ended questions were asked to investigate the emotional state of all pregnant women. The data obtained were analyzed using the descriptive phenomenological method. In quantitative analysis, responses were analyzed directly, whereas in qualitative analysis, inferences and interpretations were drawn from them.

The study was completed with 81 high-risk pregnant women, with an average age of 28.9. The total APSI score was 13.4, and the FAI score was 82.2. A significant negative correlation was found between the inventories (r=-.965; p<.001), indicating a strong association between perceived stress and antenatal attachment, which should be interpreted with caution. Five main themes were identified in the analysis of the interviews: coping with stress, partner support, duration of partner support, sharing feelings and emotions about pregnancy with the partner, and postpartum fear. While physical or psychological support is often emphasized in partner support, the frequency of conversation is reported to be associated with emotional sharing. In general, mothers with low stress levels and high partner support had healthier pregnancy.

The findings indicate that perceived stress during pregnancy is associated with adverse maternal and fetal outcomes, while partner support plays a protective role. Although the association between stress and attachment was strong, it should be interpreted cautiously and within the context of a single-center sample of primigravida women in late pregnancy. Strengthening psychosocial support during pregnancy remains essential.