Does attachment and prenatal depression affect maternal health-promoting lifestyle during pregnancy? A cross-sectional study

Abstract

Introduction A healthy lifestyle during pregnancy is crucial for improving maternal and infant outcomes. Maternal-fetal attachment and maternal prenatal depression have been identified as factors influencing maternal lifestyle during pregnancy. This study aimed to investigate the relationship between maternal-fetal attachment, maternal prenatal depression, and a healthy lifestyle among pregnant women. Methods A cross-sectional study was conducted among 224 pregnant women in their third trimester, attending an antenatal appointment at a community health center in Surakarta, Indonesia, from July to September 2019. Results Bivariate analysis revealed significant associations between education (p = 0.024), religion (p = 0.026), employment (p = 0.012), income (p = 0.016), parity (p = 0.026), maternal depression (p < 0.01), maternal-fetal attachment (p < 0.001), and a health-promoting lifestyle. However, factors such as age, living arrangement, gestational age, a planned pregnancy, previous miscarriages, pre-pregnancy diseases, pre-pregnancy complications, and a private health insurance showed no significant associations. Hierarchical multiple linear regression indicated that maternal-fetal attachment (p < 0.05) and maternal depression (p < 0.001) were the only predictors of pregnant women's health-promoting lifestyles (R2 = 0.373, ΔR = 0.251). Conclusion Maternal-fetal attachment and maternal prenatal depression are key predictors of adopting a health-promoting lifestyle during pregnancy. These findings highlight the importance of maternal psychological well-being as part of a comprehensive antenatal care.