The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study

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Abstract

Background

Smoking in pregnancy constitutes a preventable risk factor for fetal/child development and maternal-fetal attachment (MFA) seems to contain a momentum that can break the chain of adverse outcomes by promoting maternal prenatal health practices. This study aimed to explore the association of MFA with smoking at any time during pregnancy and smoking cessation in early pregnancy, and the modifying role of MFA on the expected effects of education and prenatal psychological distress (PPD) on prenatal smoking behavior.

Methods

The pregnant women ( n = 3766) participated in the The FinnBrain Birth Cohort Study in Finland between December 2011 and April 2015. The binary outcomes, smoking at any time during pregnancy and smoking cessation in early pregnancy, were obtained from self-reports at gestational weeks (gwks) 14 and 34 and The Finnish Medical Birth Register. MFA was assessed with the Maternal-Fetal Attachment Scale (MFAS) at gwks 24 and 34. Logistic regression analyses were used to determine the association between MFA and maternal prenatal smoking behavior.

Findings

The prevalence of smoking was 16.5%, and 58.1% of the smokers quit smoking during pregnancy. The independent associations of total MFA scores with prenatal smoking behavior were not established (aOR = 1.00-1.02, multiplicity adjusted p > 0.05). A higher score in the altruistic subscale of MFA, Giving of self, associated with a higher probability of smoking cessation (24 gwks: aOR = 1.13, 95% CI [1.04, 1.24], p = 0.007, multiplicity adjusted p = 0.062; 34 gwks: aOR = 1.17, 95% CI [1.07, 1.29], p < 0.001, multiplicity adjusted p = 0.008). The modifying effect of MFA on the observed associations between PPD and smoking in pregnancy and between maternal education and smoking in pregnancy / smoking cessation in early pregnancy was not demonstrated.

Conclusions

The altruistic dimension of maternal-fetal attachment associates with an increased probability of smoking cessation during pregnancy and therefore strengthening altruistic maternal-fetal attachment may constitute a promising novel approach for interventions aiming at promoting smoking cessation during pregnancy.

Related collections

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Identifying the women at risk of antenatal anxiety and depression: A systematic review

Alessandra Biaggi, Susan K. Conroy, Susan Pawlby … (2016)

Background Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. Methods A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. Results The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. Limitations The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. Conclusions The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.

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Author and article information

Contributors

Heidi Jussila:

ORCID: http://orcid.org/0000-0003-2744-5264

hemhaan@utu.fi

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 30 November 2020

Publication date PMC-release: 30 November 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 741

Affiliations

[1 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Doctoral Programme of Clinical Investigation, Department of Child Psychiatry, , University of Turku, ; Turku, Finland

[2 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, , University of Turku, ; Lemminkäisenkatu 3, 20014 Turku, Finland

[3 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Psychology , , University of Turku , ; Turku, Finland

[4 ]GRID grid.410552.7, ISNI 0000 0004 0628 215X, Department of Obstetrics and Gynecology , , Turku University Hospital , ; Turku, Finland

[5 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Child Psychiatry , , University of Turku , ; Turku, Finland

[6 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Centre for Population Health Research , , University of Turku and Turku University Hospital , ; Turku, Finland

[7 ]GRID grid.410552.7, ISNI 0000 0004 0628 215X, Department of Child Psychiatry , , Turku University Hospital and University of Turku , ; Turku, Finland

[8 ]GRID grid.410552.7, ISNI 0000 0004 0628 215X, Department of Psychiatry , , Turku University Hospital and University of Turku , ; Turku, Finland

Author information

Heidi Jussila http://orcid.org/0000-0003-2744-5264

Article

Publisher ID: 3393

DOI: 10.1186/s12884-020-03393-x

PMC ID: 7708161

PubMed ID: 33256653

SO-VID: 996893fb-9ed2-4971-8ffb-666c323a0ca4

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 24 April 2020

Date accepted : 4 November 2020

Funding

Funded by: Academy of Finland

Funded by: The Signe and Ane Gyllenberg Foundation

Funded by: Finnish State Grants for Clinical Research

Funded by: University of Turku

Funded by: Turku University Foundation

Funded by: Finnish Psychiatric Association

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: smoking in pregnancy,smoking cessation,smoking,pregnancy,prenatal,maternal-fetal attachment,prenatal parenting,prenatal stress,prenatal psychological distress,education

Data availability: