The Relationship Between Maternal-Fetal Attachment and Quality of Marital Life and Rumination in Pregnant Women With Nonclinical Depression

Depression during pregnancy may lead to reduced self–care ability, inadequate nutrition, postpartum depression, and irregular pregnancy examinations. Depression during pregnancy has numerous adverse psychological consequences, including rumination for the mother; thus, it is necessary to identify its related factors. Rumination means repetitive and passive mental engagement with a subject that increases the odds of psychopathology symptoms and causes or increases the mood disorders, such as anxiety and depression. Maternal–Fetal attachment and the quality of married life may be associated with rumination in pregnant women with nonclinical depression. Maternal–Fetal attachment gives meaning to the emotional and intimate bond of the pregnant woman with her fetus. Additionally, the quality of marital life plays a critical role in the quality of life, stability in marriage and couples health, and wellbeing. Thus, we aimed to investigate the relationship between maternal–fetal attachment and quality of marital life, and rumination in pregnant women with nonclinical depression.

The study population of this correlational research was depressed pregnant women referred to Yas Hospital affiliated with Tehran University of Medical Sciences in 2019. Considering the study's inclusion criteria, 150 women were selected by the purposive sampling method. The inclusion criteria included presenting non–clinical depression defined by a score of 11–30 based on the Depression Questionnaire (Beck & Clark, 1988), minimum 9 years of education, the age of 26–35 years, being in the third trimester of pregnancy, no substance dependence, not being under neuroleptic medications, like antidepressants and not being under psychological treatment. Participants who refused/failed to complete the questionnaires were excluded from the study. The research tools were the Maternal Attachment During Pregnancy Scale (Cranley, 1981), Marital Quality Scale (Zhang et al., 2013), Rumination Questionnaire (Nolen–Hoeksema & Morrow, 1991), and Depression Questionnaire (Beck & Clark, 1988). The obatiend data were analyzed by descriptive statistics (mean, standard deviation, frequency, percentage) and inferential statistics, such as Pearson correlation and multiple regression analysis in SPSS at the significance level of 5%.

Maternal–fetal attachment (r=–0.59, p<0.01) and the quality of marital life (r=–0.36, p<0.01) presented a negative and significant relationship with rumination in pregnant women with nonclinical depression. Furthermore, maternal–fetal attachment and quality of marital life significantly could predict 54% of the variance of rumination in the study subcjts; in this prediction, the share of maternal–fetal attachment (p<0.001, Beta=0.25) was higher than the quality of marital life (p<0.001, Beta=0.12).

Due to the effective role of maternal–fetal attachment and the quality of marital life in predicting rumination, therapists and health professionals can increase maternal–fetal attachment and the quality of marital life throughout the pregnancy by training to reduce rumination.