By: 17 September 2013

In a small new study, researchers report that pregnant smokers who felt less emotional attachment to their foetuses may have smoked more than women with greater feelings of attachment.

Dr Susanna Magee, lead author and assistant professor of family medicine in The Warren Alpert Medical School of Brown University has seen evidence of that in her 12 years of clinical practice with mothers-to-be as a physician at Memorial Hospital in Pawtucket. She and co-author Laura Stroud, a research associate professor of psychiatry and human behaviour in the Alpert Medical School based at The Miriam Hospital, decided to study it more rigorously in a subpopulation of women participating in the ‘Behavior and Mood in Babies and Mothers’ (BAM BAM) study at local hospitals.

The BAM BAM study tracks smoking during pregnancy. Subjects participate in the Timeline Follow Back interview where they are asked to recall their weekly smoking history during pregnancy. The researchers also measured participants’ saliva levels of the chemical cotinine, a metabolic byproduct of nicotine use that varies with the amount a person has smoked in the last day or so. The researchers sampled cotinine at weeks 30 and 35 of pregnancy and on the day after delivery.

For this study, the researchers also asked 58 pregnant smokers to answer the 24 questions of the ‘Maternal-Fetal Attachment Scale’ (MFAS) at weeks 30 and 35 of gestation. The scale provides a standardised assessment of each woman’s feelings about her foetus.
Women in the lower attachment group had significantly higher levels of cotinine at week 30 and on the day after delivery. At week 35 their levels were also comparatively high, but not to a statistically significant degree.

Magee said that while the study should be repeated with a larger sample, it fits within a narrative emerging in the literature that has documented associations between foetal attachment and maternal behaviour during pregnancy.