{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:29:22Z","timestamp":1786476562179,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001350","name":"Ministry of Health -Singapore","doi-asserted-by":"publisher","award":["MOH\u2010001261"],"award-info":[{"award-number":["MOH\u2010001261"]}],"id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n At\u2010risk mothers experience disproportionately higher rates of antenatal depression and anxiety, which can hinder mother\u2013infant bonding and adversely affect infant socioemotional development. Despite growing evidence on postpartum mental health, antenatal risk factors among psychosocially vulnerable mothers remain underexplored, particularly in multi\u2010ethnic Asian settings.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To identify factors associated with antenatal depression, anxiety, and maternal\u2013fetal bonding among at\u2010risk mothers.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This cross\u2010sectional observational study was nested within an ongoing randomised controlled trial. Two hundred at\u2010risk mothers, defined as single, of low socioeconomic status, referred for psychosocial support, at risk of depression, with adverse childhood experiences, or with a fetus with a congenital malformation, were recruited from outpatient obstetric clinics between February and September 2024. Participants completed online self\u2010administered questionnaires assessing antenatal depression, anxiety, perceived stress, social support, parenting self\u2010efficacy, and maternal\u2013fetal bonding. General Linear Models were used to analyse data and identify factors associated with depression, anxiety, and bonding.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Higher perceived stress was associated with increased depression (\n \u03b2<\/jats:italic>\n \u2009=\u20090.28,\n p<\/jats:italic>\n \u2009<\u20090.001) and anxiety (\n \u03b2<\/jats:italic>\n \u2009=\u20091.28,\n p<\/jats:italic>\n \u2009<\u20090.001) and poorer bonding (\n \u03b2<\/jats:italic>\n \u2009=\u20090.08,\n p<\/jats:italic>\n \u2009=\u20090.02), while greater social support predicted lower anxiety (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.31,\n p<\/jats:italic>\n \u2009<\u20090.001). Higher parenting self\u2010efficacy was linked to stronger bonding (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.09,\n p<\/jats:italic>\n \u2009=\u20090.06). Younger mothers (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22122.68,\n p<\/jats:italic>\n \u2009=\u20090.025) and Indian mothers (\n \u03b2<\/jats:italic>\n \u2009=\u20097.46,\n p<\/jats:italic>\n \u2009=\u20090.017) were particularly vulnerable to anxiety, whereas post\u2010secondary education was protective against depression (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22121.44,\n p<\/jats:italic>\n \u2009=\u20090.02). Model fit ranged from 0.14 to 0.65.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Perceived stress, social support, and parenting self\u2010efficacy significantly influenced antenatal mental health and bonding in at\u2010risk mothers. These findings underscore the need for culturally sensitive, nurse\/midwife\u2010led interventions that integrate early screening, stress reduction, and empowerment strategies within routine antenatal care to strengthen maternal mental health and early bonding outcomes.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n (1) Nurses and midwives play a critical role in screening for antenatal depression and anxiety in mothers with risk profiles highlighted in this study. (2) Culturally responsive nursing practice that demonstrates sensitivity towards sociocultural pressures is needed to provide individualised care. (3) Integration of digital and community\u2010based antenatal education programs could provide more equitable access to care for at\u2010risk mothers who may face barriers to in\u2010person care.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n (1) Despite having a higher susceptibility for antenatal mental health conditions, risk factors for antenatal depression, anxiety, and maternal\u2013infant bonding have been underexplored in at\u2010risk mothers. (2) Antenatal stress and anxiety are universally associated with depression across risk groups, while maternal self\u2010efficacy and perceived social support serve as key protective factors. (3) The findings from this study suggest the need for early screening and nurse\u2010led interventions that support maternal parenting self\u2010efficacy and stress management to improve maternal mental health outcomes among at\u2010risk mothers.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n STROBE reporting checklist.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n No patient or public contribution.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70513","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:36:18Z","timestamp":1769679378000},"page":"8671-8681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Maternal Depression, Anxiety and Mother\u2013Infant Bonding in At\u2010Risk Mothers During Pregnancy: A Cross\u2010Sectional Observational 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