Attachment Patterns and Antenatal Depressive Symptoms in Romanian Pregnant Women: Implications for Spa-based Rehabilitation Programmers

Adult attachment style (AAS) and the perceived meaning of motherhood are associated with antenatal affective vulnerability, yet their relation to plasma oxytocin (OXT) is insufficiently characterised. In a cohort of 140 Romanian pregnant women, we assessed attachment style, antenatal depressive symptoms (EPDS), and psychosocial factors (pregnancy planning, partner support, perception of motherhood). In a subsample of 35 pregnant women, we quantified morning plasma OXT from EDTA venepuncture (08:00–10:00), stored at −80 °C, and assayed by ELISA without solid-phase extraction, a methodological limitation that may reduce comparability across studies but remains appropriate for exploratory group-level analysis. EPDS severity showed graded differences across perceptions of motherhood and attachment styles. In multivariable models, negative perception and anxious–ambivalent attachment were independently associated with screen-positive depression. In the OXT subsample, concentrations varied by attachment (secure > avoidant > anxious–ambivalent) and were inversely related to EPDS scores. After adjustment, attachment remained the only independent correlate of OXT. These findings indicate that peripheral OXT co-varies with attachment organisation and antenatal depressive symptoms, while perception of motherhood provides an additional psychosocial cue relevant to triage.. Clinically, AAS, EPDS, and a standardised perception item represent a feasible screening package; OXT should be treated as a mechanistic rather than a diagnostic marker. From a rehabilitation perspective, integrating such psychosocial screening with supervised, non-pharmacological interventions— including aquatic exercise and spa-based programmes aimed at stress reduction and emotional support−may offer complementary, interdisciplinary pathways for vulnerable pregnant women. These applications remain preliminary and warrant formal feasibility testing.