BACKGROUNDMaternal-fetal attachment (MFA) is the emotional bond between a mother and her fetus and is influenced by numerous risk and protective factors during pregnancy. However, according to the literature, the results relating to the influence of these factors are mixed.METHODThe aim of the study is to identify the relationship between MFA and maternal distress, evaluated as maternal depression and anxiety, alexithymia, and perceived social support during the prenatal period in an Italian community sample. Ninety-four pregnant women completed self-report questionnaires.RESULTSResults showed that total MFA was negatively associated with maternal anxiety and alexithymia and was positively associated with social support. Moreover, maternal depression was negatively associated with the quality subscale of MFA The quality subscale of MFA was negatively associated with maternal state and trait anxiety and alexithymia and was positively associated with social support. The intensity subscale of MFA was positively associated with social support. Multiple regression showed that alexithymia and social support predicted MFA with a higher effect than maternal depression and anxiety.CONCLUSIONSThe results are useful for planning interventions aimed at supporting the mother-infant bond starting from pregnancy.