Factores predictores del vínculo afectivo prenatal en gestantes nulíparas de edad materna avanzada

Rosa María Galán López; José Luis Bartha Rasero

Rosa María Galán López Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz. Madrid, España
José Luis Bartha Rasero Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz. Madrid, España

Palabras clave: Vínculo afectivo prenatal, Técnicas de reproducción asistida, Edad materna avanzada, Gestación, Ansiedad

Key-words: Prenatal emotional attachment, Assisted reproductive technology, Advanced maternal age, Anxiety

Resumen

Objetivo principal: conocer los factores que predicen el vínculo afectivo prenatal en gestantes nulíparas de edad materna avanzada que consiguieron gestación mediante técnicas de reproducción asistida en comparación con las que lo consiguieron espontáneamente. Metodología: estudio observacional, descriptivo y transversal, constituido gestantes nulíparas de edad materna avanzada sometidas o no a técnicas de reproducción asistida. Resultados principales: el vínculo afectivo prenatal se correlacionó positivamente con las gestantes que presentaban mayor estabilidad laboral (p= 0,02), mayor nivel de estudios (p=0,04) y con las que se seguían formando académicamente (p<0,001). El vínculo afectivo prenatal fue menor en aquellas que padecieron alguna patología materna durante la gestación (p= 0,01) y en las que presentaron mayores niveles de ansiedad-Estado (p>0,001) y Rasgo (p<0,001). Conclusión principal: Los factores predictores del vínculo afectivo prenatal fueron una mayor estabilidad laboral, seguir formándose académicamente y presentar menores niveles de ansiedad-Estado. Los dos primeros son factores protectores, la ansiedad-Estado se consideraría factor de riesgo.

Abstract

Objective: to understand the factors that predict prenatal emotional attachment in nulliparous pregnant women of advanced maternal age who achieved pregnancy through assisted reproduction techniques compared to those who conceived spontaneously. Methods: observational, descriptive, and cross-sectional study, consisting of nulliparous pregnant women of advanced maternal age who achieved pregnancy spontaneous conception or through assisted reproductive technology. Results: prenatal emotional attachment was positively correlated with pregnant women who had greater job stability (p=0,02), higher education levels (p=0,04), and were continuing their academic education (p<0,001). The prenatal emotional attachment was lower in those who experienced any maternal pathology during pregnancy (p=0,01) and those who had higher levels of State-anxiety (p<0,001) and Trait-anxiety (p<0,001). Conclusions: predictive factors of prenatal emotional attachment include greater job stability, continuing academic education, and lower levels of State-anxiety. The first two are protective factors, while State-anxiety would be considered a risk factor.

Bibliografía

Rodríguez AR, Pérez López J, Brito AG. La vinculación afectiva prenatal y la ansiedad durante los últimos tres meses del embarazo en las madres y padres tempranos. Un estudio preliminar. Anales de psicología. 2004; 20(1): 93-102. https://dialnet.unirioja.es/servlet/articulo?codigo=876875

Kumar RC. “Anybody’s child”: Severe disorders of mother-to- infant bonding. Br J Psychiatry. 1997; 171: 175–81. http://doi.org/10.1192/bjp.171.2.175

Salisbury A, Law K, LaGasse L, Lester B. Maternal-fetal attachment. JAMA. 2003; 289(13): 1701. http://doi.org/10.1001/jama.289.13.1701

Grimalt O, Heresi, M. Estilos de apego y representaciones maternas durante el embarazo. Rev. Chil. Pediatr. 2012; 83(3): 239-246. http://doi.org/10.4067/S0370-41062012000300005

Souter VL, Hopton JL, Penney, GC, Templeton, AA. Survey of psychological health in women with infertility. J. Psychosom Obstet Gynaecol. 2002; 23(1): 41–49. http://doi.org/10.3109/01674820209093414

Gourounti K. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women Health. 2016; 56(1), 98-118. http://doi.org/10.1080/03630242.2015.1074642

Rini CK, Dunkel-Schetter C, Wadhwa PD, Sandman CA. Psychological adaptation and birth outcomes: the role of personal resources, stress, and sociocultural context in pregnancy. Health Psychol. 1999; 18(4): 333-345. http://doi.org/10.1037//0278-6133.18.4.333

Zhu P, Tao F, Hao J, Sun Y, Jiang X. Prenatal life events stress: implications for preterm birth and infant birthweight. Am J Obstet Gynecol. 2010; 203(1): 34e1-34.e348. http://doi.org/10.1016/j.ajog.2010.02.023

Khashan AS, McNamee R, Abel KM, et al. Reduced infant birthweight consequent upon maternal exposure to severe life events. Psychosom Med. 2008; 70(6): 688-694. http://doi.org/10.1097/PSY.0b013e3181779940d

Darwiche J, Lawrence C, Vial Y, et al. Anxiety and psychological stress before prenatal screening in first-time mothers who conceived through IVF/ICSI or spontaneously. Women Health. 2014; 54(5): 474–485. http://doi.org10.1080/03630242.2014.897677

Lafuente, MJ. La escala EVAP (Evaluación de la Vinculación Afectiva y la Adaptación Prenatal): Un estudio piloto.Index Enferm. 2008; 17(2): 133-137. https://bit.ly/48XWkFw

Spielberger CD, Sydeman SJ, Owen AE, Marsh, BJ. Measuring anxiety and anger with the state-trait anxiety inventory (STAI) and the state-trait anger expression inventory (STAXI). M.E. Maruish. 1999; 2: 993-1021. https://books.google.com/books?id=CNWzuXlCJjcC&pg=PA993

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(2): 145–46. http://doi.org/10.18502/ijrm.v18i2.6425

Yoshimasu K, Miyauchi N, Sato A, et al. Japan Environment and Children´s Study Group. Assisted reproductive technologies are slightly associated with maternal lack of affection toward the newborn. J. Obstet. Gynaecol Res. 2020; 46(3): 434-44. http://doi.org/10.1111/jog.14189

Shieh C, Kravitz,M, Wang HH. What do we know about maternal-fetal attachment? Kaohsiung J Med Sci. 2001; 17(9): 448–54. http://doi.org/11842647

Fisher JRW, Hammarberg K, Baker GHW. Antenatal mood and fetal attachment after assisted conception. Fertil Steril. 2008; 89(5): 1103–1112. http://doi.org/10.1016/j.fertnstert.2007.05.022

Kuo PC, Bowers B, Chen YC, Chen CH, Tzeng YL, Lee MS. Maternal-fetal attachment during early pregnancy in Taiwanese women pregnant by in vitro fertilization. J Adv Nur. 2013; 69(11): 2502–2513. http://doi.org/10.1111/jan.12135

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(6): 419–27. http://doi.org/10.17265/2159-5542/2014.06.002

Covington, S.N. Pregnancy after infertility. Infertility counselling: A comprehensive handbook for clinicians. Pearl River, New York: The Parthenon Publishing Group. 1999; 425-447.

Ranjbar F, Warmelink C, Mousavi R, Gharacheh M. Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study. Int J Reprod Biomed. 2022; 19(12): 1075-1084. http://doi.org/10.18502/ijrm.v19i12.10058

McMahon CA, Boivin J, Gibson FL, 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(6): 1389–1398. http://doi.org/10.1093/humrep/der076

Hashemieh C, Neisani 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(2): e14465. http://doi.org/10.5812/ircmj.14465

Pohárnok M, Kopcsó K, Polgár PI. The structure and correlates of the 20 item Maternal-Fetal Attachment Scale in a population-based sample of Hungarian expectant women. Midwifery. 2022; 112: 103422. http://doi.10.1016/j.midw.2022.103422

Hjelmstedt A, Widström AM, Collins A. Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth. 2006; 33(4): 303–310. http://doi.org/10.1111/j.1523-536X.2006.00123.x

Marín C. Factores asociados a la vinculación prenatal materna en gestantes atendidas en el Centro de Salud Yugoslavia-Nuevo Chimbote 2017. 2018.

Conger RD, Conger KJ, Martín MJ. Socioeconomic status, family processes and individual development. J Marriage Family. 2010; 72(3): 685-704. http://doi.org/10.1111/j.1741-3737.2010.00725.x

Chen CJ, Chen YC, Sung HC, Kuo PC, Wang CH. Perinatal attachment in naturally pregnant and infertility-treated pregnant women in Taiwan. J Adv Nur. 2011; 67(10): 2200–2008. http://doi.org/10.1111/j.1365.2648.2011.05665.x

Alvarenga P, Dazzani M, Alfaya C, Lordelo E, Piccini C. RelaÇoes entre a Saúde mental da gestante e o apego materno-fetal. Estud Psicol. 2012; 17(3): 477-484. https://doi.org/10.1590/S1413-294X2012000300017

Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006; 60(1): 7-12. http://doi.org/10.1136/jech.2004.023531

Yarcheski A, Mahon NE, Yarcheski TJ, Hanks MM, Cannella, BL. A meta-analytic study of predictors of maternal-fetal attachment. Int J Nurs Stud. 2009; 46(5): 708-15. http://doi.org/10.1016/j.ijnurstu.2008.10.013

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(7): e0220032. http://doi.org/10.1371/journal.pone.0220032

Factores predictores del vínculo afectivo prenatal en gestantes nulíparas de edad materna avanzada

Predictors of Prenatal Emotional Attachment in Nulliparous Pregnant Women of Advanced Maternal Age

Resumen

Abstract

Bibliografía