Body perception, spouse harmony and prenatal attachment effect on fetal growth in pregnant women

Introduction and General Information: Many changes occur in women during pregnancy. These changes may cause some difficulties and troubles in the life of the pregnant woman. Many problems can be experienced such as changing the relationship between the pregnant woman's spouse, social problems, economic problems, general health problems, changing body appearance and structure, the care and responsibility of the new baby to join the family . Since pregnancy is a period of emotional changes as well as physical changes, the reactions of the spouse affect the woman's perception of the body, as well as the perception of the body of the pregnant woman and the reactions to the changes that take place. The mother, whose body perception is positive, perceives pregnancy positively, it is easy to conform to pregnancy, and the attachment between mother and baby begins. When we examine the literature on the subject; Studies on the effects or attachment of the mother with her unborn baby on the intrauterine development of the baby are not sufficient. The effect of pregnant's perception of the body, partner compliance and prenatal attachment factors on fetal growth has not been investigated before. With this research, the question marks on this issue will be clarified and perhaps this will contribute to healthy baby births by interfering with some variables that may be effective in fetal growth during pregnancy. Material and Method: The sample of the study consisted of 191 volunteers who were admitted to Ankara City Hospital Obstetrics and Gynecology and Obstetrics Outpatient Clinic and accepted to participate in the study, and whose routine obstetric evaluation was performed for 10-28 weeks. Our pregnant women who participated in the study filled in a questionnaire consisting of Voluntary Information and Consent Form and then short socio-demographic information, Beck depression scale, Beck anxiety scale, Body liking scale, Double adjustment scale, Prenatal attachment inventory. In addition, the first trimester fetal anomaly scan, second trimester fetal anomaly scan and third trimester obstetric ultrasound (USG) measurements were evaluated routinely by the attending physician. In our study, descriptive statistics were expressed as mean ± standard deviation or median (percentage between quarters) for continuous variables, and discrete variables with frequency and%. Binary comparisons were again compared to independent sample t test or Mann-Witney U test according to distribution characteristics, and repeated measurements were compared with dependent sample t test. The relationship between continuous variables was examined with spearman or pearson correlation tests and finally, theoretical models that reveal the relationships between the variables affecting fetal growth in each trimester were tested. In comparative statistics, the threshold value was accepted as p <0.05 for significance. Results: 191 pregnant women were included in the study. The average age of the participants was 27.9 and on average 4.9 years were married women. As the mother's depression level increases, the fetal CRL value decreases significantly and weakly. (p <0.05) While there is a significant and moderately positive correlation between the mother's depression levels and anxiety, there is a negative correlation with body perception. There is a significant negative relationship between mother's anxiety levels and body perception. Finally, there is a significant, weak and positive relationship between the mother's perception of the body and couple compliance and prenatal attachment levels. There is a weak-moderate, negative and significant relationship between mother's BDO scores and AFP and AFP-M. In other words, as maternal depression levels increase, AFP and AFP-M values decrease. There is a weak-moderate, negative and significant relationship between maternal anxiety levels and the amount of amnion and E3. In other words, as mother anxiety levels increase, the amount of E3 and amnion decreases. The prenatal attachment scores of the mother and E3 and E3-M levels are moderately positive and significantly related. In other words, as the level of attachment of the mother to her baby increases, E3 and E3-M increase. In the second trimester, while the mother's depression and anxiety levels showed a positive, medium-sized and significant relationship, she had a negative relationship with body liking and couple compliance. As the mother's level of anxiety increases, the level of body liking decreases significantly. A weak, moderate to significant level was found between prenatal attachment, body liking and couple compliance. While there was a positive and moderate relationship between the mother's depression levels and anxiety levels in the third trimester, there was a negative and moderate relationship with body liking scores. There is a negative and moderate relationship between mother's anxiety levels and body liking scores. Body liking scores also have a positive and moderate relationship with prenatal attachment scores. During pregnancy, a decrease in borderline compliance with significant significance was found. During pregnancy, prenatal attachment points increased significantly. According to Model 1, there is a mutual and significant relationship between the mother's anxiety, depression levels, and couple compliance. As the mother's anxiety levels increase, the mother's perception of the body is negatively affected, while the mother's body perception is positively affected as the couple's compliance increases. The change in body perception affects the prenatal attachment levels in the same direction and the nuchal thickness decreases as the attachment levels increase. According to Model 2, double compliance has a positive effect on prenatal attachment and body liking scores. The way the woman perceives the body of the pregnant negatively affects the anxiety and depression levels of the pregnant woman. In other words, if the pregnant woman perceives her body positively, anxiety and depression decreases, while the negative perceives her anxiety and depression. Finally, the effect on fetal parameter PAP-A is based on depression scores. As depression scores increase, PAP-A scores increase. According to Model 3, double compliance in the 2nd Trimester affects prenatal attachment both directly and indirectly through depression and body liking. Unlike the 1st trimester, prenatal attachment levels positively and moderately affect maternal E3 levels, and increased E3 values increase fetal BPD. Conclusion: In our study, it was found that there was no change in the levels of depression, anxiety and body perception of pregnant women in three periods of pregnancy. In our study, we found that after 3 trimesters, couple adjustment decreased somewhat and prenatal attachment increased gradually during pregnancy. In our study, we modeled the relationship between depression and anxiety levels of pregnant women during pregnancy, couple compliance, body perception of pregnant women, prenatal attachment levels and fetal parameters. Accordingly, in the first model, we found that double compliance, depression and anxiety levels impair the body perception of pregnant women, impaired body perception negatively affects prenatal attachment and as a result, fetal nuchal thickness increases. In this modeling, the most important is to determine the relationship between the two factors as well as to determine which of these two factors is the factor and which is the result. In this follow-up study, where we made measurements for each of the three periods of pregnancy, we tried to simplify the network of complex relationships between these factors by examining the role of the psychological factors of the mother in fetal growth and development with different models. The main finding of our study is that the importance of maternal psychological factors decreases in fetal growth and development in the first two trimesters after the third trimester, and that intervention should be made in the early stages of intervention to expectant mothers with depressive and anxiety symptoms. For early intervention, the early detection of anxiety and depression in pregnant women applying for follow-up, as well as the evaluation of women's moods together with couple adjustment, body perception and prenatal attachment levels will have positive effects on fetal development.