Skip to main content
NUTRITION 2025 Main banner

Nutrition Education and Behavioral Science (Poster Session)

(P16-002-25) Impact of Prenatal Cash Transfers and Nutrition Intervention on Perinatal Maternal Attachment in Bangladesh

Sunday, June 1, 2025
12:45 PM – 1:45 PM ET
Location: Poster Board A-96

    Presenting Author(s)

  • Fahmida Akter, PhD (she/her/hers)

    Recent PhD Graduate in Public Health
    University of South Carolina
    Panama City, Florida, United States

    • Co-Author(s)

  • AP

    Aklima Parvin, MSc

    International Food Policy Research Institute
    Washington, District of Columbia, United States

  • SR

    Shalini Roy, PhD

    Senior Research Fellow
    International Food Policy Research Institute
    Washington, District of Columbia, United States

  • MA

    Moira Angel

    International Food Policy Research Institute, United States

  • Edward A. Frongillo, Jr., PhD (he/him/his)

    Professor and Director of Global Health Initiative
    University of South Carolina
    Columbia, South Carolina, United States

  • Jef L L. Leroy, PhD

    Senior Research Fellow
    International Food Policy Research Institute
    Washington, DC, District of Columbia, United States

  • Leila M. Larson, PhD

    Assistant Professor
    University of South Carolina
    Columbia, South Carolina, United States

Disclosure(s):
Fahmida Akter, PhD, MBA, MS: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Household and psychosocial conditions (e.g., food security, family relationship, maternal stress) can shape perinatal attachment. This study tested whether adding fortified foods or top-up cash to the Bangladesh government's standard Mother and Child Benefit Programme (MCBP), which targets critical drivers of attachment, improves maternal-fetal and maternal-infant attachment.

Methods: This cluster-randomized trial was conducted in six rural subdistricts in Bangladesh. We recruited 4,620 pregnant women in their second trimester who were MCBP-eligible (e.g., aged 20-35 y, from a poor household, and in their first or second pregnancy). The 144 study clusters (ward groups) were randomly assigned to one of three study arms: 1) Standard MCBP (~7.40 USD monthly cash transfer and nutrition education), 2) Standard MCBP + top-up cash of ~9.25 USD (during pregnancy), or 3) Standard MCBP + fortified foods (during pregnancy). Data were collected at the second pregnancy trimester (study enrolment), at the third trimester, and at two months postpartum. Maternal-fetal attachment was assessed in the third trimester using Prenatal Attachment Inventory. Maternal-infant attachment was assessed at two months postpartum using Postpartum Bonding Questionnaire. Intervention impact was estimated as the difference in mean scores between arms using cluster-adjusted mixed-effects regression. All analyses were intent to treat.

Results: At enrollment, socioeconomic and demographic characteristics were similar among study arms. In the third trimester, no differences in maternal-fetal attachment were found across arms. At two months postpartum, maternal-infant attachment was better in women who received food transfers during pregnancy than women in the standard MCBP arm (geometric mean ratio:1.36, 95% CI: 1.07-1.71, p=0.01). Intervention effects from food transfers were observed for each subscale of maternal-infant attachment, e.g., impaired bonding, infant-focused anxiety, and rejection. No effect occurred in the top-up cash arm.

Conclusions: Fortified foods with a base cash transfer during pregnancy can improve maternal-infant attachment. The lack of effect in the top-up cash arm could be related to cash being used by others and for purposes unrelated to maternal and infant health, warranting further research.

Funding Sources: Bill & Melinda Gates Foundation