Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Promotion

First Committee Member

Dr. Abbie Raikes, PhD, MPH

Second Committee Member

Dr. Chris Wichman, PhD

Third Committee Member

Dr. John Ditekemena, MD, PhD, MPH


Maternal-fetal attachment is defined as the relationship of affection that exists between the pregnant woman and her fetus during pregnancy. It increases throughout the pregnancy and predicts not only the attachment style between the mother and the child but also the chances of optimal socioemotional development during infancy. The Maternal Antenatal Attachment Scale measures the Maternal-Fetal Attachment (MFA). Several versions of this scale have been adapted in various parts of the world. However, to date no study has been conducted on the validation of this scale in sub-Saharan Africa and the identification of factors associated with the MFA. This cross-sectional study aimed to investigate the psychometric properties of MAAS and to identify MFA correlates in the Democratic Republic of Congo. Data of 220 pregnant women were collected from January to March 2019 in the antenatal services of three hospitals in Kinshasa. The MAAS demonstrated acceptable psychometric properties. The two-factor structure of Condon’s original scale was not confirmed. The exploratory factor analysis showed a four-factor structure with only one having an acceptable internal consistency. On the other hand, the global scale also presented an acceptable internal consistency after the withdrawal of questions 7 and 12. The binary logistic regression showed pregnant women with a partner with high age, high parity, and positive HIV status were more likely to present a low attachment in comparison to their peers. A history of infertility, the pregnant women religion, and the method of conception did not influence the MFA. The Congolese version of the MAAS can be used to measure MFA. Identification of MFA correlates can inform policies and guide interventions to optimize social development during childhood.