From parental-fetal attachment to a parent-infant relationship: a systematic review about prenatal protective and risk factors

Developing an attachment to an unborn child is considered a milestone of the parent-fetus relationship is related to the quality of the postnatal parent-infant relationship. We have aimed to provide an overview of the recent findings highlighting factors that can influence parental prenatal attachment and the postpartum parent-child relationship. PubMed and PsycINFO were systematically explored looking for longitudinal studies, published from 2005 to 2016, reporting clearly the prenatal attachment measures used. We found 28 studies heterogeneous for sampling techniques, sample size and periods of assessment. Studies considered a broad range of individual, relational and contextual variables as potential risk or protective factors, but no one has of yet evaluated the interaction between them. The main focus remains on mothers. From these studies emerged conflicting and difficult to generalize results, and this does not facilitate the understanding of the phenomenon investigated. The current literature needs to be integrated with more longitudinal studies using comparable tools and periods of observation, at either a normal or at risk sample. There is also need for additional studies focused on fathers and couples, and considering the effects of the fetal behavior on the development of prenatal attachment.