The importance of attachment during the prenatal period has become a well-recognised area of research over the last 30 years. This paper aims to review the role of psychological and relational factors in relation to prenatal attachment over the last decade, with consideration to both typical and more complex pregnancy groups. The findings were evaluated in response to a number of key questions and their methodological strengths. The overall findings support the notion of the significance of psychological and relational factors. A pertinent finding was the importance of relational factors and cognitive appraisals irrespective of pregnancy complications or losses. However, disparities existed across studies in relation to factors measured; this is a likely consequence of differing measurement tools, making conclusions and comparisons across studies problematic. Further research is required to establish causations such as implementing comparative and longitudinal designs. The review highlights the importance of a woman.s psychological health and well-being to those working in maternity services providing better outcomes for women.