Pregnancy Intendedness and Happiness as Predictors of Maternal-Fetal Bonding: Evidence for Mediation

• In Event: Poster Session 09
  In Poster Session: PS 09 Topic - Parenting & Parent-Child Relationships

Abstract

Background
Nearly half (45%) of all pregnancies in the United States are unintended (Finer & Zola, 2016). Unintended births are associated with numerous adverse consequences for maternal and child health and development (Brown & Eisenberg, 1995; Shah et al., 2011), due, in part, to disruptions in mother-infant bonding (Kinsey & Hupcey, 2013). Pregnancy intentions are strongly, though not entirely, correlated with happiness (Aiken et al., 2015; Sable & Libbus, 2000; Santelli et al., 2009). Happiness about a pregnancy, even if it is unintended, has important implications for infant outcomes; women who reported higher levels of happiness when they found out they were pregnant, for example, are more likely to breastfeed (Hartnett, 2012; Kost & Lindberg, 2015) and less likely to use substances during pregnancy (Blake et al., 2007).

We examined the relationships among the intendedness of a pregnancy (i.e., intended, ambivalent, or unintended), happiness, and maternal-fetal bonding using structural equation modeling (SEM) in a longitudinal sample. We hypothesized a significant direct relationship between pregnancy intendedness and bonding and that pregnancy happiness would serve as a mediator between intendedness and bonding.

Methods
Data for the current study came from a longitudinal urban clinic-based cohort study involving 177 pregnant women (ages 16-38) recruited in 2017-2018 in a South-Central U.S. state. The participating clinics serve a racially diverse and socioeconomically disadvantaged patient population. The sample for the current study was restricted to the 145 participants who responded to the first two survey waves (first and second trimesters of pregnancy). Pregnancy intendedness and happiness were measured at the first assessment. Maternal-fetal bonding was measured at the second assessment with the Prenatal Attachment Inventory (Müller & Mercer, 1993; Siddiqui et al., 1999).

Results
Mediation analysis with SEM was conducted using Mplus software. Total number of births was used as a control variable for pregnancy happiness. The resulting model demonstrated excellent fit to the data (Kline, 2016): 2 = 0.19 (df = 1), p = .66; root mean square error of approximation (RMSEA) = .00, 90% confidence interval (CI) [.00, .15]; comparative fit index (CFI) = 1.00; standardized root mean square residual (SRMR) = .01. The path diagram of the model (Figure 1) includes the unstandardized estimates for the causal paths of the indirect and direct effects. The estimated paths of intended to pregnancy happiness and pregnancy happiness to bonding were positive and significant, while the direct effect from intended to bonding was not significant, indicating evidence for mediation. Unintended and ambivalent pregnancies were not found to have any significant paths connecting them to pregnancy happiness or bonding.

Conclusion
Maternal-fetal bonding has several benefits for both the mother and her fetus, such as their well-being pre- and postpartum (Hassan & Hassan, 2017). However, several factors related to the pregnancy can influence this bonding, including intendedness (Yarcheski et al., 2009). Results suggest that maternal-fetal bonding is a complex aspect of pregnancy and that pregnancy happiness can be a critical factor to consider. These results could inform interventions interested in bonding by emphasizing the importance of pregnancy happiness.

Authors

• Jens E Jespersen, Oklahoma State University - Center for Health Sciences
  Presenting Author

• Ashley N Quigley, Oklahoma State University - Stillwater
  Non-Presenting Author

• Karina M. Shreffler, University of Oklahoma Health Sciences Center
  Non-Presenting Author