Psychometric evaluation of the Brazilian version of the MaternalFetal Attachment Scale

Authors

Keywords:

Epidemiology, Maternal-fetal relations, Primary health care, Psychometrics, Validation study

Abstract

Objective
This study aimed to evaluate the psychometric properties of the Brazilian version of the Maternal-Fetal Attachment Scale applied to pregnant women in Primary Health Care.
Method
This is a methodological study conducted with 937 pregnant women assisted in the Family Health Strategy in Montes Claros, Minas Gerais, Brazil. Psychometric sensitivity, construct and criterion validity, and reliability were evaluated.
Results
The instrument achieved adequate psychometric sensitivity (skewness < 3 and kurtosis < 7). Quality fit indicators of the model were obtained: x2/gl = 4.72, CFI = 0.89, GFI = 0.90, TLI = 0.87, RMSEA = 0.063 (90% CI = 0.059-0.067, p = 0.000). Hypothesis testing indicated associations with marital status (p = 0.036), income (p= 0.030), trimester (p < 0.001), planned pregnancy (p = 0.003), social support (p < 0.001), and family APGAR score (p < 0.001). Significant correlations (p < 0.001) with stress (r = -0.12) and depressive symptoms (r = -0.17) demonstrated divergent criterion validity. Cronbach’s α of 0.874 was recorded.
Conclusion
The scale showed adequate psychometric evidence for application to pregnant women in the Primary Health Care setting

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References

Andrek, A., Kekecs, Z., Hadhazi, E., Boukydis, Z., & Varga, K. (2016). Re-evaluation of the psychometric properties of the Maternal-Fetal Attachment Scale in a Hungarian sample. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(5), e15–e25. https://doi.org/10.1016/j.jogn.2016.05.005

Baptista, M. N., Muniz, M., Reppold, C. T., Nunes, C. H. S. S., Carvalho, L. F., Primi, R., Noronha, A. P. P., Seabra, A. G., Wechsler, S., & Pasquali, L. (2019). Compêndio da Avaliação Psicológica (1st ed.). Vozes.

Bowlby J. (2002). Apego: A natureza do vínculo (3rd ed.). Martins Fontes.

Busonera, A., Cataudella, S., Lampis, J., Tommasi, M., & Zavattini, G. C. (2017). Prenatal attachment inventory: Expanding the reliability and validity evidence using a sample of Italian women. Journal of Reproductive and Infant Psychology, 35(5), 462–479. https://doi.org/10.1080/02646838.2017.1349896

Busonera, A., Cataudella, S., Lampis, J., Tommasi, M., & Zavattini, G. C. (2016). Psychometric properties of a 20-item version of the Maternal-Fetal Attachment Scale in a sample of Italian expectant women. Midwifery, 34, 79–87. https://doi.org/10.1016/j.midw.2015.12.012

Castaño, J. H. O., Carrascal, G. C., & Rodríguez, M. D. L. Á. G. (2019). Apego materno-fetal: Un análisis de concepto. Revista Habanera de Ciencias Médicas, 18(6), 969–982. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2019000600969

Cavalcante, M. C. V., Lamy, F., França, A. K. T. D. C., & Lamy, Z. C. (2017). Relação mãe-filho e fatores associados: análise hierarquizada de base populacional em uma capital do Brasil-Estudo BRISA. Ciência & Saúde Coletiva, 22(5), 1683–1693. https://doi.org/10.1590/1413- 81232017225.21722015

Cohen J. (1988). Statistical power analysis for the behavioral sciences. NJ Erlbaum.

Cranley, M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30(5), 281–284. https://doi.org/10.1097/00006199-198109000-00008

Cunha, C. M., Almeida Neto, O. P., & Stackfleth, R. S. (2016). Principais métodos de avaliação psicométrica da confiabilidade de instrumentos de medida. Revista de Atenção à Saúde, 14(49), 98–103. https://doi.org/10.13037/ras.vol14n49.3671

Doan, H. M., Cox, N. L., & Zimerman, A. (2003). The maternal fetal attachment scale: Some methodological ponderings. Journal of Prenatal & Perinatal Psychology & Health, 18(2), 167–188.

Doster, A., Wallwiener, S., Müller, M., Matthies, L. M., Plewniok, K., Feller, S., Kuon, R.-J., Sohn, C., Rom, J., Wallwiener, M., & Reck, C. (2018). Reliability and validity of the German version of the maternal-fetal attachment scale. Archives of Gynecology and Obstetrics, 297(5), 1157–1167. https://doi.org/10.1007/s00404-018-4676-x

Duarte, Y. A. D. O. (2001). Família: Rede de suporte ou fator estressor: A ótica de idosos e cuidadores familiares [Tese de doutorado não-publicada]. Escola de Enfermagem da Universidade de São Paulo.

Feijó, M. C. C. (1999). Validação brasileira da “Maternal-Fetal Attachment Scale”. Arquivos Brasileiros de Psicologia Aplicada, 51(4), 52–62.

Fernandes, R. C. L., & Rozenthal, M. (2008). Avaliação da sintomatologia depressiva de mulheres no climatério com a escala de rastreamento populacional para depressão CES-D. Revista de Psiquiatria do Rio Grande do Sul, 30(3), 192–200. https://doi.org/10.1590/S0101-81082008000400008

Griep, R. H., Chor, D., Faerstein, E., Werneck, G. L., & Lopes, C. S. (2005). Validade de constructo de escala de apoio social do Medical Outcomes Study adaptada para o português no Estudo Pró-Saúde. Cadernos de Saúde Pública, 21(3), 703–714. https://doi.org/10.1590/S0102-311X2005000300004

Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2009). Análise multivariada de dados (6th ed.). Bookman editora.

Koss, J., Bidzan, M., Smutek, J., & Bidzan, L. (2016). Influence of perinatal depression on labor-associated fear and

emotional attachment to the child in high-risk pregnancies and the first days after delivery. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 22, 1028–1037. https://doi.org/10.12659/msm.895410

Laros, J. A. (2004). O uso da análise fatorial: Algumas diretrizes para pesquisadores. In L. Pasquali (Org.), Análise fatorial para pesquisadores (pp. 163–193). Vozes.

Lauriola, M., Panno, A., Riccardi, C., & Taglialatela, D. (2010). La misura dell’ attaccamento materno prenatale: Un confronto psicométrico di tre strumenti di valutazione. Infanzia e Adolescenza, 9(3), 6403. https://doi.org/10.1710/535.6403

Lingeswaran, A., & Bindu, H. (2012). Validation of tamil version of Cranley’s 24-item maternal-fetal attachment scale in indian pregnant women. The Journal of Obstetrics and Gynecology of India, 62(6), 630–634. https://doi.org/10.1007/s13224-012-0175-3

Luft, C. D., Sanches, S. O., Mazo, G. Z., & Andrade, A. (2007). Versão brasileira da Escala de Estresse Percebido: tradução e validação para idosos. Revista de Saúde Pública, 41(4), 606–615. https://doi.org/10.1590/S0034-89102007000400015

Maroco, J. P. (2010). Análise de equações estruturais. Fundamentos teóricos, software & aplicações. Report Number.

Maroco, J. P., & Garcia-Marques, T. (2006). Qual é a fiabilidade do alfa de Cronbach? Questões antigas e soluções modernas? Laboratório de Psicologia, 4(1), 65–90. https://repositorio.ispa.pt/handle/10400.12/133

McNamara, J., Townsend, M. L., & Herbert, J. S. (2019). A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLos One, 14(7), e0220032. https://doi.org/10.1371/journal.pone.0220032

Mesman, J., Minter, T., Angnged, A., Cissé, I., Salali, G. G., & Migliano, A. B. (2018). Universality without uniformity: A culturally inclusive approach to sensitive responsiveness in infant caregiving. Child Development, 89(3), 837–850. https://doi.org/10.1111/cdev.12795

Mokkink, L. B., Prinsen, C. A. C., Bouter, L. M., Vet, H. C. W., & Terwee, C. B. (2016). The Consensus-based standards for the selection of health Measurement instruments (COSMIN) and how to select an outcome measurement instrument. Brazilian Journal of Physical Therapy, 20(2), 105–113. https://doi.org/10.1590/bjpt-rbf.2014.0143

Napoli, A., Lamis, D. A., Berardelli, I., Canzonetta, V., Sarubbi, S., Rogante, E., Napoli, P.-L., Serafini, G., Erbuto, D., Tambelli, R., Amore, M., & Pompili, M. (2020). Anxiety, prenatal attachment, and depressive symptoms in women with diabetes in pregnancy. International Journal of Environmental Research and Public Health, 17(2), 425. https://doi.org/10.3390/ijerph17020425

Navarro-Aresti, L., Iraurgi, I., Iriarte, L., & Martínez-Pampliega, A. (2016). Maternal Antenatal Attachment Scale (MAAS): Adaptation to Spanish and proposal for a brief version of 12 items. Archives of Women’s Mental Health, 19, 95–103. https://doi.org/10.1007/s00737-015-0513-4

Noblega, M., Barrig, P., & Fourmen, K. (2019). Maternal care and attachment security in preschool children. Psicologia Teoria e Pesquisa, 35, e3534. https://doi.org/10.1590/0102.3772e3534

Ozcan, H., Ustundag, M. F., Yilmaz, M., Aydinoglu, U., Ersoy, A. O., & Eyi, E. G. Y. (2019). The relationships between prenatal attachment, basic personality traits, styles of coping with stress, depression, and anxiety, and marital adjustment among women in the third trimester of pregnancy. The Eurasian Journal of Medicine, 51(3), 232–236. https://doi.org/10.5152/eurasianjmed.2019.15302

Pasquali, L. (2017). Validade dos testes. Examen, 1(1), 14-48. https://examen.emnuvens.com.br/rev/article/view/19

Perrelli, J. G. A., Zambaldi, C. F., Cantilino, A., & Sougey, E. B. (2014). Mother-child bonding assessment tools. Revista Paulista de Pediatria, 32(3), 257–265. https://doi.org/10.1590/0103-0582201432318

Ribeiro, S. V. O., Batista, R. F. L., Ribeiro, M. R. C., Pessoa, K. C., Simões, V. M. F., Figueiredo, F. P. D., & Bettiol, H. (2019). Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach. Revista Brasileira de Saúde Materno Infantil, 19(1), 173–184. https://doi.org/10.1590/1806-93042019000100010

Rocha, P. C., Britto e Alves, M. T. S. S., Chagas, D. C., Silva, A. A. M., Batista, R. F. L., & Silva, R. A. (2016). Prevalência e fatores associados ao uso de drogas ilícitas em gestantes da coorte BRISA. Cadernos de Saúde Pública, 32(1), e00192714. https://doi.org/10.1590/0102-311X00192714

Rollè, L., Giordano, M., Santoniccolo, F., & Trombetta, T. (2020). Prenatal attachment and perinatal depression: A systematic review. International Journal of Environmental Research and Public Health, 17(8), 2644. https://doi.org/10.3390/ijerph17082644

Roncallo, C. P., Miguel, M. S., & Freijo, E. A. (2015). Vínculo materno-fetal: Implicaciones en el desarrollo psicológico y propuesta de intervención en atención temprana. Escritos de Psicología, 8(2), 14–23. https://doi.org/10.5231/psy.writ.2015.0706

Rubertsson, C., Pallant, J. F., Sydsjö, G., Haines, H. M., & Hildingsson, I. (2015). Maternal depressive symptoms have a negative impact on prenatal attachment – Findings from a Swedish community sample. Journal of Reproductive and Infant Psychology, 33(2), 153–164. https://doi.org/10.1080/02646838.2014.992009

Ruschel, P., Zielinsky, P., Grings, C., Pimentel, J., Azevedo, L., Paniagua, R., & Nicoloso, L. H. (2014). Maternalfetal attachment and prenatal diagnosis of heart disease. European Journal of Obstetrics & Gynecology and Reproductive Biology, 174, 70–75. https://doi.org/10.1016/j.ejogrb.2013.11.029

Salehi, K., Taleghani, F., & Kohan, S. (2019). Effect of attachment-based interventions on prenatal attachment: A protocol for systematic review. Reproductive Health, 16, 42. https://doi.org/10.1186/s12978-019-0704-y

Schmidt, E. B., & Argimon, I. I. L. (2009). Vinculação da gestante e apego materno fetal. Paidéia, 19(43), 211–220. https://doi.org/10.1590/S0103-863X2009000200009

Silveira, D. X., & Jorge, M. R. (1998). Propriedades psicométricas da escala de rastreamento populacional para depressão CES-D em populações clínica e não-clínica de adolescentes e adultos jovens. Revista de Psiquiatria Clínica, 25(5), 251–261.

Souza, A. C., Alexandre, N. M. C., & Guirardello, E. B. (2017). Psychometric properties in instruments evaluation of reliability and validity. Epidemiologia e Serviços de Saúde, 26(3), 649–659. https://doi.org/10.5123/s1679-49742017000300022

Teixeira, M. I. F., Raimundo, F. M. M., & Antunes, M. C. Q. (2016). Relação da vinculação materno-fetal com a idade gestacional e as memórias parentais. Revista de Enfermagem Referência, 4(8), 85–92. https://doi.org/10.12707/RIV15025

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Published

2025-03-17

How to Cite

Lima, C. de A., Brito, M. F. S. F., de Pinho, L., Andrade, J. S., Santos, V. M., Marôco, J., & Silveira, M. F. (2025). Psychometric evaluation of the Brazilian version of the MaternalFetal Attachment Scale. Psychological Studies (Campinas), 41. Retrieved from https://seer.sis.puc-campinas.edu.br/estpsi/article/view/15162

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Section

HEALTH PSYCHOLOGY

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