Adverse Childhood Experiences and Maternal–Fetal Attachment: Indirect Associations via Prenatal Depressive Symptoms in a Romanian Sample

Abstract

Adverse childhood experiences (ACEs) have been associated with increased vulnerability to depressive symptoms during pregnancy and may also be related to emerging prenatal relational processes. This cross-sectional study examined whether prenatal depressive symptoms statistically accounted for the association between ACEs and maternal–fetal attachment (MFA), and whether this indirect association varied as a function of perceived social support from partners, family, and friends. The sample included 149 Romanian women in the first trimester of their first pregnancy. Participants completed self-report measures assessing ACEs, prenatal depressive symptoms, MFA, and perceived social support. Conditional process analyses were conducted using PROCESS Model 7, controlling for maternal age and perceived socioeconomic status. Higher ACEs were significantly associated with increased prenatal depressive symptoms (b = 0.43, p = 0.001), which in turn were associated with lower MFA (b = −0.03, p = 0.023). The indirect association between ACEs and MFA via prenatal depressive symptoms was statistically significant (b = −0.01, 95% CI [−0.028, −0.0009]). However, perceived social support from partners, family, and friends did not significantly moderate this indirect association. These findings provide preliminary evidence that prenatal depressive symptoms represent an important psychological correlate linking early-life adversity with lower MFA in early pregnancy. Given the cross-sectional design, findings should be interpreted as indirect associations rather than causal mediation.