Maternal–fetal attachment differentiates patterns of prenatal smoking and exposure

Abstract

Objective Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers. Methods Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 weeks gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers. Results At 30 weeks, pregnancy quitters scored higher on the ‘giving of self’ subscale compared to persistent smokers (21.6 ± 2.4 versus 19.9 ± 2.9; p = .004). Maternal ‘giving of self’ also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9 ± 2.9 versus 21.2 ± 2.2; p = .002). Controlling for age, income, unemployment, gravida, and father’s smoking status, ‘giving of self’ differentiated pregnancy quitters from persistent smokers [OR = 5.144; 95% C.I. 1.509 – 17.538; B (SE) = 1.638 (.626); p = .009]. Conclusions Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.

Tobacco exposure and maternal psychopathology: Impact on toddler problem behavior

“…In order to take into account the fluctuations in a woman’s smoking throughout pregnancy (e.g., Pickett, Wakschlag, Dai, & Leventhal, 2003) and address the potential limitation of categorizing women as smokers vs. non-smokers, future research should assess these smoking patterns and the impact that subsequent dose and timing differences may have on child outcomes (e.g., Estabrook et al, 2016; Hutchinson et al, 2009). Incorporating additional familial and maternal characteristics in models investigating the connection between PTE and problem behavior (e.g., genetic risk, maternal personality traits, and maternal fetal attachment; Knopik, 2009; Massey et al, 2015; 2016) is another important area for future work. As discussed, the toddler period may also be early to investigate the full impact of PTE on problem behavior.…”

Vínculo materno-fetal. Implicaciones en el desarrollo psicológico y propuesta de intervención en Atención Temprana

“…En su estudio plantean cómo los procesos conductuales y psíquicos que se ponen de manifiesto al dejar de fumar, difieren esencialmente en mujeres no embarazadas y embarazadas, ya que para estas últimas el deseo de cuidar y proteger al feto actúa como motivación principal para reducir el consumo y en la posterior abstinencia; menor vínculo materno-fetal se asocia con un mayor número de cigarrillos por día durante todo el embarazo. Por otra parte, las mujeres que lograron una reducción considerable del consumo argumentaban el bienestar del bebé como motivación principal, afirmación que denota un comportamiento altruista, empatía y filiación afectiva hacia el feto (Massey et al, 2015). Resultados similares fueron hallados por Sedgmen et al (2006), quienes observaron una reducción significativa en el número de copas ingeridas en mujeres con problemas de abuso de alcohol, asociadas al incremento del vínculo materno-fetal.…”

Separating Family-Level and Direct Exposure Effects of Smoking During Pregnancy on Offspring Externalizing Symptoms: Bridging the Behavior Genetic and Behavior Teratologic Divide

“…The few existing studies that have specifically compared smokers who quit early in pregnancy (pregnancy quitters) with smokers who continued smoking during pregnancy (persistent pregnancy smokers) have shown significant differences in history of antisocial behavior between these groups (Wakschlag, Pickett, Middlekamp et al, 2003; Kodl & Wakschlag, 2004; Pickett, Wilkinson, & Wakschlag, 2009; McGrath et al, 2012). Importantly, while never smokers may differ from ever smokers, pregnancy quitters are also significantly different from persistent pregnancy smokers (Massey, Bublitz, Magee, et al, 2015, Massey, Estabrook, O’Brien et al, 2015). Broadly speaking, the continuum of never smokers, pregnancy quitters, and persistent pregnancy smokers may represent a continuum of risk.…”