The Relationship Between Pregnancy Stress and Maternal Attachment, Postpartum Depression, and Breastfeeding Self-Efficacy: A Descriptive and Prospective study

Year 2025, Volume: 15 Issue: 3, 481 - 488, 30.09.2025

Bihter Akın , Süreyya Kılıç , Sema Yılmaz

https://doi.org/10.33808/clinexphealthsci.1461184

Abstract

Objective: This study aimed to examine the relationship between pregnancy stress and maternal attachment, postpartum depression risk, and breastfeeding self-efficacy.
Methods: This study was designed as a descriptive and prospective study. A total of 237 pregnant women were included. The Pregnancy Stress Rating Scale (PSRS) was administered at hospital admission for delivery. The Maternal Attachment Scale (MAS), Edinburgh Postpartum Depression Scale (EPDS), and Breastfeeding Self-Efficacy Scale (BSES) were used in the 1st and 3rd months postpartum.
Results: The mean PSRS score was 75.76±28.25, indicating moderate stress. Mean maternal attachment scores were 100.26±7.00 (1st month) and 102.55±5.12 (3rd month), while EPDS scores were 17.05±3.51 and 19.17±2.59, suggesting high depression risk. Breastfeeding self-efficacy decreased from 59.16±14.63 to 52.44±17.69. A positive correlation was found between PSRS and maternal attachment (r =.32, p <.001), while PSRS was negatively correlated with breastfeeding self-efficacy (r = –.28, p=.002) and positively with EPDS (1st: r = .35; 3rd: r =.41; p <.001). Maternal attachment and breastfeeding self-efficacy were positively correlated (r =.39, p <.001), while both were negatively correlated with EPDS scores (p <.05).
Conclusion: Pregnancy stress is associated with increased postpartum depression risk, reduced breastfeeding self-efficacy, and higher maternal attachment. These findings highlight the need for early stress screening and psychosocial support during and after pregnancy.

Keywords

Pregnancy , stress , attachment , postpartum depression risk , breastfeeding

Ethical Statement

In order to conduct the study, approval was secured from the Clinical Research Ethics Committee in Turkey (No: 2021/581). Pregnant women who consented to participate were duly informed about the study's objectives, with assurance of confidentiality regarding their identity information. Written consent was obtained from the pregnant participants using a Voluntary Information Form.

Supporting Institution

The study was conducted without any available funding.

Project Number

Yok

Thanks

The authors express thanks to pregnant women in the sample for participation in the study.

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