Introduction
Maternal health trajectories during perinatal period are influenced by both protective and risk factors, with adverse childhood experiences, social support, quality of the couple relationship and antenatal attachment being particularly significant. Identifying distinct profiles can provide clinically meaningful insights for prevention and intervention, especially when early adversities and current relational functioning are considered togheter.


Purpose
This study aimed to identify groups of pregnant women based on childhood trauma, couple functioning, and attachment to the fetus, and to interpret their significance as trajectories in which past and present relational experiences intersect.


Method
A sample of N = 774 pregnant women completed self-report measures assessing adverse childhood experiences (CTQ-SF), perceived social support (MSSS), couple relationship quality (DAS), and maternal antenatal attachment (MAAS). After preprocessing (KNN imputation, z-score scaling), clustering was performed using K-means (k = 3), validated with BIC and silhouette indices. Clusters were described through descriptive statistics and tested for between-group differences (ANOVA/Kruskal-Wallis with post-hoc comparisons).


Results
Three distinct relational profiles were identified:
Fragile Balance (31%): a profile of "moderate vulnerability," navigating past adversities with limited protective relational resources.
Trauma-related vulnerability (15%): a "high-risk" profile, in which unresolved childhood trauma affects the functioning of the adult couple, while maintaining a high level of attachment to the fetus.
Resilient Bonds (54%): a protective configuration. Here, secure couple functioning and strong antenatal attachment serve as buffers against early adversity.
Differences across clusters were highly significant (p < .001) for most CTQ-SF and DAS items.


Conclusions
Rather than simple gradients of low-to-high risk, the clusters illustrate how early adversities and adult relational quality intertwine. Childhood trauma may undermine trust and regulation capacities, weakening the protective role of the couple bond; conversely, resilient relational dynamics can mitigate the long-term impact of adversity and influence maternal attachment to the fetus. .