Antenatal anksiyete ve prenatal bağlanma arasındaki ilişkide travmatik doğum algısının aracı rolü: Kesitsel bir araştırma

Yıl 2025, Cilt: 12 Sayı: 3, 439 - 446, 30.09.2025

Merve Murat Mehmed Ali , Elif Zahide Çelebi , Elif Tozkır

Öz

Giriş ve Amaç: Antenatal anksiyete, erken doğum, düşük doğum ağırlığı ve zayıflamış anne-fetus bağlanması gibi olumsuz obstetrik sonuçlarla ilişkilendirilmiştir. Son dönemdeki bulgular, kadınların doğumu travmatik olarak algılamasının bu ilişkiyi etkileyebileceğini göstermektedir; ancak travmatik doğum algısının aracılık rolü üzerine yeterli çalışma bulunmamaktadır. Bu çalışmanın amacı, antenatal anksiyetenin prenatal bağlanma üzerindeki etkisini ve bu ilişkide travmatik doğum algısının aracı rolünü incelemektir.
Gereç ve Yöntem: Kesitsel ve ilişkisel tipte olan bu çalışma, Ağustos - Kasım 2024 tarihleri arasında İstanbul, Türkiye'deki bir hastanede rutin antenatal bakım alan 233 gebe kadın ile yürütüldü. Veri toplama araçları olarak Kişisel Bilgi Formu, Stirling Antenatal Anksiyete Ölçeği, Travmatik Doğum Algısı Ölçeği ve Prenatal Bağlanma Envanteri kullanıldı. Aracılık analizi, dolaylı etkilerin tahmini için PROCESS Makro (Model 4) kullanılarak 5000 bootstrap örnekleme ile gerçekleştirildi.
Bulgular ve Sonuç: Antenatal anksiyete, travmatik doğum algısı ile pozitif yönde (β = 1.83, p < .01), prenatal bağlanma ile ise negatif yönde ilişkili bulundu (β = -0.75, p < .01). Travmatik doğum algısı da prenatal bağlanma ile negatif yönde ilişkilidir (β = -0.11, p < .01). Aracılık analizi, travmatik doğum algısının antenatal anksiyete ile prenatal bağlanma arasındaki ilişkide kısmi aracılık etkisine sahip olduğunu gösterdi(dolaylı etki: γ = -0.194, SH = 0.067, %95 GA [-0.335, -0.072]). Bulgular, travmatik doğum algısının antenatal anksiyetenin anne-fetus bağlanması üzerindeki negatif etkisinde anlamlı bir aracı rol üstlendiğini göstermektedir. Bu sonuçlar, antenatal bakım hizmetlerinde anksiyete ve travmaya ilişkin inançların erken dönemde taranmasının, psikolojik hazırlığı ve duygusal bağlanmayı desteklemek açısından önemli olduğunu vurgulamaktadır.

Anahtar Kelimeler

Antenatal anksiyete , Anne-bebek bağlanması , Aracılık analizi , Gebelik , Travmatik doğum

Etik Beyan

Araştırma için Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan etik kurul onayı (Karar No: 19; Tarih: 21 Şubat 2024) ve kurum izni (Belge No: E-15916306-604.01-249212659; Tarih: 26 Temmuz 2024) alındı. Çalışma, Helsinki Bildirgesi doğrultusunda gerçekleştirildi. Veriler yüz yüze anket yöntemi ile toplanmış olup, tüm katılımcılardan bilgilendirilmiş onam alındı.

Destekleyen Kurum

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Teşekkür

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Traumatic childbirth perception as a mediator between antenatal anxiety and prenatal attachment: A cross-sectional study

Öz

Background and Aim: Antenatal anxiety has been associated with adverse obstetric outcomes such as preterm birth, low birth weight, and impaired maternal–fetal bonding. Emerging evidence suggests that women’s perception of childbirth as traumatic may influence this relationship; however, the mediating role of traumatic birth perception remains understudied. This study aimed to investigate the effect of antenatal anxiety on prenatal attachment and to investigate the mediating role of traumatic childbirth perception in this association.
Methods: The cross-sectional and correlational study was conducted with 233 pregnant women attending routine antenatal care at a hospital Istanbul, Türkiye between August - November 2024. Data was collected using a Personal Information Form, Stirling Antenatal Anxiety Scale, Traumatic Childbirth Perception Scale, and Prenatal Attachment Inventory. Mediation analysis was conducted using PROCESS Macro (Model 4) with 5000 bootstrap resamples to estimate indirect effects.
Results and Conclusion: Antenatal anxiety was positively correlated with traumatic childbirth perception (β = 1.83, p < .01), and both were negatively associated with prenatal attachment (β = -0.75 and β = -0.11, respectively; p < .01). Mediation analysis confirmed that traumatic childbirth perception partially mediated the relationship between antenatal anxiety and prenatal attachment (indirect effect: γ = -0.194, SE = 0.067, 95% CI [-0.335, -0.072]). Traumatic birth perception plays a significant mediating role in the negative impact of antenatal anxiety on maternal–fetal attachment. These findings highlight the importance of early screening for anxiety and trauma-related beliefs in antenatal care settings to promote psychological preparedness and emotional bonding.

Anahtar Kelimeler

Antenatal anxiety , Maternal–fetal attachment , Mediation analysis , Pregnancy , Traumatic childbirth

Etik Beyan

For the study, ethics committee approval was obtained from the Zeynep Kamil Women and Children’s Diseases Training and Research Hospital Clinical Research Ethics Committee (Decision No: 19; Date: February 21, 2024) and institutional permission was obtained from a training and research hospital (Document No: E-15916306-604.01-249212659; Date: July 26, 2024). Data were collected through face-to-face surveys and all participants provided informed consent.

Destekleyen Kurum

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Teşekkür

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Kaynakça

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