Construct validity and reliability of the Brazilian version of the Maternal-Fetal Attachment Scale (MFAS): a proposal for a 12-item short version

Abstract

This study aimed to update the assessment of construct validity and reliability of the Brazilian version of the Maternal-Fetal Attachment Scale (MFAS). This is part of a cohort study, in which the scale was applied to 415 pregnant women. The factor structure was verified via structural equation models. Comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA) were used to verify the model fit. Additionally, to test the validity of the MFAS based on external variables, generalized linear model was performed to test the association between obstetric variables, social support, and symptoms of depression with the MFAS. The reliability was analyzed via the composite reliability coefficient (CR). The 12-item short version of the Brazilian MFAS showed adequate parameters of construct validity (CFI = 0.969, TLI = 0.960 and RMSEA = 0.032, 90%CI: 0.012-0.048) and is composed of three factors (“empathy and care”, “role-taking”, and “interaction with the fetus”) containing 12 items. The total scores of the MFAS were positively correlated with social support (p-value < 0.001) and negatively correlated with depressive symptoms (p-value = 0.007). Moreover, women who live with a partner (p-value = 0.026) and had intended pregnancies (p-value < 0.001) presented a better bond with the fetus. Regarding reliability, factors 1 and 2 showed adequate values (CR = 0.72 and CR = 0.82, respectively) and factor 3 regular value (CR = 0.63). This 12-item short version of the Brazilian MFAS may be a reliable and valid instrument for scientific studies and clinical assistance in Brazil.