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In studying this leading cause of neonatal mortality, the authors hypothesized that the psychological attitude of the mother is a prime factor in the absence of organic pathology. A personal interview and a battery of psychological tests were administered to a group of thirty mothers who delivered prematurely and to an equal number of matched controls. The data were then scored for sixty-seven items under four headings: maternal attitudes, femininity, mental stability, and familial-social relationships. Subsequently, when an independent rater rescored the protocols devoid of all cues relating to prematurity, statistical agreement was found.
Although no specific psychiatric syndrome was elicited and the attitudes of the matched groups overlapped considerably, striking individual differences in scores were sufficient to differentiate the controls and subjects. 'In general the premature mother tends to be young, immature, narcissistically concerned with her body image, and insecure in her feminine identification and development.' In contrast to Chertok's study of vomiting in pregnancy where ambivalence predominated, the mothers who delivered prematurely were more overtly negative and hostile toward the foetus and had many destructive fantasies about delivery.
From the pilot study the authors have designed a multiple-choice questionnaire about the Maternal Attitude to Pregnancy which may help predict the premature terminators and alert the obstetrician to their need for greater support during their pregnancies.