Emotional State, Maternal Attitude and Mother–Fetus Interaction During Pregnancy in Women with Gestational Diabetes Mellitus

The prevalence of gestational diabetes mellitus (GDM) continues to rise worldwide, reaching 10–20% among pregnant women in Russia. GDM not only complicates the course of pregnancy but is also associated with changes in the woman’s emotional state, which affects her attitude toward pregnancy, childbirth, and the formation of her relationship with the child. Understanding the nature of these changes requires studying the specific features of women with GDM, comparing them with those without carbohydrate metabolism disorders, and examining the relationship between emotional state and maternal attitudes toward the child. The aim of this study was to investigate the characteristics of emotional state, maternal attitude, and mother–child interaction during pregnancy in women with gestational diabetes mellitus. The participants were 47 women aged M (SD) = 32 (6) years at 28.5 (6.3) weeks of gestation, including 19 with GDM and 28 without carbohydrate metabolism disorders. The following tools were used: Beck Anxiety Inventory, Beck Depression Inventory, Edinburgh Postnatal Depression Scale, Test of Attitudes of Pregnant Women, Maternal Antenatal Attachment Scale (MAAS), and a socio-demographic questionnaire. The results showed that women with GDM, compared to women without GDM, had higher scores on the behavioral component of maternal attitudes toward the child during the prenatal period and a less pronounced depressive type of attitude toward pregnancy. Correlations between anxiety, depression, and maternal attitudes toward the child were more harmonious in women without GDM, whereas in women with GDM, they reflected greater tension and a stronger bodily-affective orientation. Women with GDM more often perceived fetal movements as active and endowed them with emotional meaning, which may indicate a compensatory enhancement of orientation toward the child against a background of emotional vulnerability. These findings highlight the importance of comprehensive care for pregnant women with GDM, including psychological support and regular monitoring of emotional well-being.

Abdulaeva, A. M., Korgozha, M. A. (2024). The maternal position of women raising single or twin infants: A review of Russian and foreign studies. Psikhologiia cheloveka v obrazovanii, 6 (1), 18–32. https://doi.org/10.33910/2686-9527-2024-6-1-18-32 (In Russian)

Basina, R. M., Palaus, E. I., Mahauri, K. M., Fesenko, N. K., Abzalieva, A. D., Bogan, N. V., Grechanyi, S. V., Khavkin, A. I. (2020). Interrelations between baby eating behaviours and the development of the mother — infant relationships and maternal anxiety and depression levels. Voprosу detskoi dietologii, 18 (3), 99–110. https://www.doi.org/10.20953/1727-5784-2020-3-99-110 (In Russian)

Blokh, M. E., Grandilevskaya, I. V., Savenysheva, S. S., Anikina, V. O. (2023). Suicidal risks of women during pregnancy and after childbirth. Konsultativnaia psikhologiia i psikhoterapiia, 31 (2), 84–98. https://doi.org/10.17759/cpp.2023310204

Blokh, M. E. (2020). The phenomenon of motherhood in the context of psychological theories and research. In: N. G. Neznanov (ed.). Zhenskoe psikhicheskoe zdorov’e: ot isterii k genderno-sensitivnomu podkhodu (pp. 38–51). St. Petersburg, Alef-Press Publ. (In Russian)

Bokhan, T. G., Silaeva, A. V. (2021). Formation of attachment to the child during pregnancy and after childbirth in women participating in the IVF program. Uchenye zapiski universiteta imeni P. F. Lesgafta, 6 (196), 401–408. (In Russian)

Branjerdporn, G., Meredith, P., Wilson, T., Strong, J. (2022). Infant developmental outcomes: Influence of prenatal maternal-fetal attachment, adult attachment, maternal well-being, and perinatal loss. Int.J. Environ. Res. Public Health, 19 (4), 2433. https://www.doi.org/10.3390/ijerph19042433

Brish, K. (2019). Bindung psychotherapy: Infancy and early age. Moscow, Terevinf Publ. (In Russian)

Brutman, V. I., Filippova, G. G., Khamitova, I. Yu. (2002). Dynamics of women psychological status during pregnancy and after the delivery. Voprosy psikhologii, 1, 59–68. (In Russian)

Carone, N., Tracchegiani, J., Lingiardi, V. (2025). Maternal attachment state of mind and defensive functioning in pregnancy: Predicting mother — infant relationship at 6 monthsthrough the PDM-2 Infancy and Early Childhood section. Front. Psychol., 16, 1568620. https://doi.org/10.3389/fpsyg.2025.1568620

Cınar, N., Yalnızoğlu Caka, S., Topal, S., Uslu Yuvacı, H. (2021). Relationship between prenatal and maternal attachment: A longitudinal study from Turkey. Journal of Obstetrics and Gynaecology, 42 (2), 220–227. https://doi.org/10.1080/01443615.2021.1904223

Dobryakov, I. V. (2015). Perinatal Psychology. 2nd ed. St. Petersburg, Piter Publ. (In Russian)
Filippova, G. G. (2024). Psychology of motherhood: textbook for universities. Moscow, Yurait Publ. (In Russian)

Hildingsson, I., Rubertsson, C. (2022). Postpartum bonding and association with depressive symptoms and prenatal attachment in women with fear of birth. BMC Pregnancy Childbirth, 22, 66. https://doi.org/10.1186/s12884-021-04367-3

Lucassen, N., Tharner, A., van Ijzendoorn, M., Bakermans-Kranenburg, M. J., Volling, B. L., Verhulst, F. C., Lambregtse — Van den Berg, M. P., Tiemeier, H. (2011). The association between paternal sensitivity and infant-father attachment security: A meta-analysis of three decades of research. Journal of Family Psychology, 25 (6), 986–992. https://www.doi.org/10.1037/a0025855

Maatz, H.-J. (2017). Lilith complex. The dark side of motherhood. Moscow, Kogito-Tsentr Publ. (In Russian)

Medina, N. Yu., Edwards, R. C., Zhang, Yu., Hans, S. L. (2021). A longitudinal investigation of young mothers’ prenatal attachment, depressive symptoms, and early parenting behaviour. Journal of Reproductive and Infant Psychology, 40 (2), 196–211. https://doi.org/10.1080/02646838.2021.1886257

Medina, N. Yu., Edwards, R. C., Hans, S. L. (2025). Young mothers’ prenatal attachment and later attachment-related representations of their young children. Infant Mental Health Journal, 46 (3), 285–297. https://www.doi.org/10.1002/imhj.22162

Muller, M. E. (1996). Prenatal and postnatal attachment: A modest correlation. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 25 (2), 161–166. https://www.doi.org/10.1111/j.1552-6909.1996.tb02420.x

Osofsky, J. D., Osofsky, H. J., Frazer, A. L., Fields-Olivieri, M. A., Many, M., Selby, M., Holman, S., Conrad, E. (2021). The importance of adverse childhood experiences during the perinatal period. American Psychologist, 76 (2), 350–363. https://www.doi.org/10.1037/amp0000770

Pazzagli, C., Buratta, L., Cenci, G., Coletti, E., Giuliani, M. L., Mazzeschi, C. (2022). Does parental reflective functioning mediate the associations between the maternal antenatal and postnatal bond with the child in a community sample? International Journal of Environmental Research and Public Health, 19 (12), 6957. https://doi.org/10.3390/ijerph19126957

Planalp, E. M., O’Neill, M., Braungart-Rieker, J. M. (2019). Parent mind-mindedness, sensitivity, and infant affect: Implications for attachment with mothers and fathers. Infant Behavior and Development, 57, 101–330.

Savenysheva, S. S., Anikina, V. O., Blokh, M. E. (2022a). Translation and adaptation of the inventory “Maternal Prenatal Attachment” (MAAS). Konsul’tativnaia psikhologiia i psikhoterapiia, 30 (3), 92–111. https://doi.org/10.17759/cpp.2022300306 (In Russian)

Savenysheva, S. S., Vasilenko, V. E., Deeva, A. A. (2022b). Attitude towards the child, maternal mental health, and infant mental development during a pandemic. Problemy sovremennogo pedagogicheskogo obrazovaniia, 75 (2), 393–397. (In Russian)

Trombetta, T., Giordano, M., Santoniccolo, F., Vismara, L., Della Vedova, A. M., Rolle, L. (2021). Pre-natal attachment and parent-to-infant attachment: A systematic review. Front. Psychol., 12, 620942. https://www.doi.org/10.3389/fpsyg.2021.620942

Znamenskaya, I. I., Yaroslavtseva, T. G. (2022). Maternal attachment to the fetus: Factors of formation and practical application of the construct. Psikhologicheskii zhurnal, 43 (2), 72–83. (In Russian)

Miroshnik, E. V., Ryumina, I. I., Zubkov, V. V. (2016). The influence of maternal diabetes on newborn health. Akusherstvo i ginekologiia, 9, 45–49. (In Russian)

Monk, C., Lugo-Candelas, C., Trumpff, C. (2019). Prenatal developmental origins of future psychopathology: Mechanisms and pathways. Annual Review of Clinical Psychology, 15, 317–344. https://doi.org/10.1146/annurev-clinpsy-050718-095539

NHS England. (2025). National Pregnancy in Diabetes Audit Dashboard 2024 (1 January 2022 to 31 December 2024). NHS Digital. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/national-pregnancy-in-diabetes-audit/2024 (accessed: 13.10.2025).

Ohene-Agyei, P., Gamble, G. D., Tran, T., Harding, J. E., Crowther, C. A. (2025). Gestational diabetes and mental health: Longitudinal analysis of data from the GEMS randomized trial. Archives of Women’s Mental Health, 28, 819–830. https://doi.org/10.1007/s00737-024-01551-0

Penner, F., Rutherford, H. J. V. (2022). Emotion regulation during pregnancy: A call to action for increased research, screening, and intervention. Archives of Women’s Mental Health, 25 (2), 527–531. https://doi.org/10.1007/s00737-022-01204-0

Rolle, L., Giordano, M., Santoniccolo, F., Trombetta, T. (2020). Prenatal attachment and perinatal depression: A systematic review. International Journal of Environmental Research and Public Health, 17 (8), 2644. https://doi.org/10.3390/ijerph17082644

Rosstat. (2023). Healthcare in Russia: Statistical yearbook. Moscow, Federal State Statistics Service Press. (In Russian)

Savenysheva, S. S., Anikina, V. O., Blokh, M. E. (2022). Translation and adaptation of the “Maternal Antenatal Attachment Scale” (MAAS). Konsul’tativnaia psikhologiia i psikhoterapiia, 30 (3), 92–111. https://doi.org/10.17759/cpp.2022300306 (In Russian)

Startseva, N. M., Bannikova, S. A., Rudneva, O. D., Mukovnikova, E. V. (2022). Psychological component of pregnancy dominance in patients with gestational diabetes mellitus. Akusherstvo i ginekologiia: novosti, mneniia, obuchenie, 10 (3), 21–25. https://doi.org/10.33029/2303-9698-2022-10-3-21-25

Sun, M., Luo, M., Wang, T., Wei, J., Zhang, S., Shu, J., Zhong, T., Liu, Y., Chen, Q., Zhu, P., Qin, J. (2023). Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China. BMJ Open Diabetes Research & Care, 11 (2), e003324. https://doi.org/10.1136/bmjdrc-2023-003324

Wang, Z., Liu, L., Shaui, H., Cai, Zh., Fu, X., Liu, X., Liu, Yu., Xiao, X., Zhang, W., Krabbendam, E., Liu, Sh., Liu, Zh., Li, Zh., Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 11, 543. https://doi.org/10.1038/s41398-021-01663-6

World Health Organization. (1989). St. Vincent Declaration on Diabetes Care and Research in Europe. St. Vincent.