[en] Background:(1) Maternal-fetal attachment should be assessed in Primary Health Care. Background:(2) Depressive symptoms were negatively related to maternal-fetal attachment. Background:(3) Social support and family functionality had a positive effect on attachment. Background:(4) Greater household crowding had a negative effect on the outcome. Background:(5) It is recommended to screen pregnant women with depression, poor social and family support. to analyze maternal-fetal attachment and interrelated factors in pregnant women assisted in Primary Health Care. a cross-sectional, population-based, analytical epidemiological survey. A sample of 937 participants attended by Family Health Strategy teams was investigated. Maternal-fetal attachment (outcome), sociodemographic and clinical variables, social support, family functionality, depressive symptoms and perceived stress were assessed. Multivariate analysis was adopted using structural equation modeling. maternal-fetal attachment had an average of 92.6 (SD=±15.3). The adjusted structural model showed that the following factors had a direct effect on the outcome: gestational weeks (β=0.29; p<0.001), household crowding (β=-0.07; p=0.027), depressive symptoms (β=-0.11; p=0.003), social support (β=0.08; p<0.001) and family functionality (β=0.19; p<0.001). Indirect effects of social support (β=-0.29; p<0.001) and family functionality (β=-0.20; p<0.001) were identified, mediated by depressive symptoms. a set of interrelationships was identified between maternal-fetal attachment, gestational weeks, household crowding, depressive symptoms, social support and family functionality. It is suggested that the Family Health Strategy offer prenatal care anchored in integrality and humanization, which promotes biopsychosocial well-being during pregnancy and healthy maternal-fetal attachment.

[pt] analisar o apego materno-fetal e os fatores inter-relacionados em gestantes assistidas na Atenção Primária à Saúde. inquérito epidemiológico seccional, de base populacional e analítico. Foi investigada a amostra de 937 participantes, assistidas por equipes da Estratégia Saúde da Família. Avaliaram-se apego materno-fetal (desfecho), variáveis sociodemográficas e clínicas, apoio social, funcionalidade familiar, sintomas depressivos e estresse percebido. Foi adotada análise multivariada por meio da modelagem com equações estruturais. o apego materno-fetal apresentou média de 92,6 (DP=±15,3). O modelo estrutural ajustado evidenciou que os seguintes fatores exerceram efeito direto sobre o desfecho: semanas gestacionais (β=0,29; p<0,001), aglomeração do domicílio (β=-0,07; p=0,027), sintomas depressivos (β=-0,11; p=0,003), apoio social (β=0,08; p<0,001) e funcionalidade familiar (β=0,19; p<0,001). Foram identificados efeitos indiretos do apoio social (β=-0,29; p<0,001) e da funcionalidade familiar (β=-0,20; p<0,001), mediados pelos sintomas depressivos. identificou-se um conjunto de inter-relações entre apego materno-fetal, semanas gestacionais, aglomeração domiciliar, sintomas depressivos, apoio social e funcionalidade familiar. Sugere-se que a Estratégia Saúde da Família oferte uma atenção pré-natal ancorada na integralidade e humanização, que propicie o bem-estar biopsicossocial na gravidez e o apego materno-fetal saudável.