abstract Study Objective: To describe self-reported maternal-fetal emotional attachment in adolescent women over the course of pregnancy, compare it with adult pregnant women, and identify risk factors for poor attachment. Design: A prospective cohort study. Setting: Young mothers' clinics in 2 public hospitals in metropolitan Melbourne, Australia. Participants: English-speaking young women aged 20 years and under attending their first antenatal visit. Methods: Self-report questionnaires were completed in each trimester. Validated measures were used to assess anxiety and depression symptoms and maternal-fetal emotional attachment. Data were analyzed with existing data from pregnant adults. Regression analyses were conducted to establish factors independently associated with higher mean first-trimester attachment score and lowest-quartile third trimester score adjusting for confounding variables. Main Outcome Measure: Maternal-fetal emotional attachment, assessed by the Quality and Intensity subscales and Global score on Maternal Antenatal Attachment Scale (MAAS).