Background This study aimed to investigate the mediating role of pregnancy-related anxiety (PRA) in the relationship between fetal movement self-monitoring adherence (FMSMA) and maternal–fetal attachment (MFA) among women in the third trimester. Methods A cross-sectional study was conducted among 348 pregnant women in their third trimester recruited from the Boai Hospital of Zhongshan between January and December 2024. Data were collected using a general information questionnaire, the FMSMA Scale (FMSMAS), the Pregnancy-Related Anxiety Scale, and the Maternal Antenatal Attachment Scale. Pearson's correlation analysis was used to examine the relationships among the variables, and the mediating effect was tested using Hayes' PROCESS macro (Model 4). Results FMSMA was positively correlated with MFA ( r = 0.291, p 0.001) and negatively correlated with PRA ( r = –0.221, p 0.001). PRA negatively correlated with MFA ( r = –0.182, p 0.001). After controlling for sociodemographic and obstetric characteristics, the mediation analysis indicated that FMSMA had a significant indirect effect on MFA through reduced PRA (indirect effect = 0.088, Bootstrap 95% CI: 0.043–0.133 M, p 0.05), accounting for 30.66% of the total effect. Conclusion PRA partially mediates the relationship between FMSMA and MFA. Enhancing adherence to self-monitoring may help reduce pregnancy-related anxiety and strengthen maternal–fetal attachment. However, due to the cross-sectional nature of this study, causal relationships cannot be confirmed, and these findings should be interpreted with caution.
Zheng et al. (Wed,) studied this question.