Previous prenatal as a predictor of perinatal depression and anxiety

Department of Psychiatry, University of Rochester Medical Center, New York, NY 14642-8409, USA.
The British journal of psychiatry: the journal of mental science (Impact Factor: 7.99). 03/2011; 198(5):373-8. DOI: 10.1192/bjp.bp.110.083105
Source: PubMed


Prenatal loss, the death of a fetus/child through miscarriage or stillbirth, is associated with significant depression and anxiety, particularly in a subsequent pregnancy.
This study examined the degree to which symptoms of depression and anxiety associated with a previous loss persisted following a subsequent successful pregnancy.
Data were derived from the Avon Longitudinal Study of Parents and Children cohort, a longitudinal cohort study in the west of England that has followed mothers from pregnancy into the postnatal period. A total of 13,133 mothers reported on the number and conditions of previous perinatal losses and provided self-report measures of depression and anxiety at 18 and 32 weeks' gestation and at 8 weeks and 8, 21 and 33 months postnatally. Controls for pregnancy outcome and obstetric and psychosocial factors were included.
Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P<0.01) and anxiety (β = 0.14, s.e. = 0.05, P<0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors. This association remained constant across the pre- and postnatal period, indicating that the impact of a previous prenatal loss did not diminish significantly following the birth of a healthy child.
Depression and anxiety associated with a previous prenatal loss shows a persisting pattern that continues after the birth of a subsequent (healthy) child. Interventions targeting women with previous prenatal loss may improve the health outcomes of women and their children.

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    • "gitudinal Study of Parents and Children Cohort — ALSPAC) [26] "
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    ABSTRACT: The objective of this study was to evaluate the relationship between psychology and pregnancy loss. A literature review was conducted by consulting Medline until April 2014. Psychological factors appear to be significantly associated with the risk of recurrent miscarriage. Depression and anxiety are common symptoms after miscarriage. A return to normal scores of depression and anxiety is frequently found in one year. A systematic psychological treatment after an episode of miscarriage seems to not bring obvious benefits, one year after a miscarriage, in terms of anxiety and depression. After a stillbirth, psychological impacts on the couple, such as anxiety and depressive symptoms, are common. An empathetic and respectful attitude of all medical and paramedical team at the support is associated with better psychological experience. After a pregnancy loss, psychological consequences are common and usually reversible. An attitude of empathy is desirable in order to accompany patients and to consider a future pregnancy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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    • "However, studies which have examined prenatal, perinatal, and post-natal losses have generally found no differences in symptomatology across types of loss (Dyregrov, 1990), although one study has reported more symptomatology following post-natal compared to prenatal loss (Gaudet, Séjourné, Camborieux, Rogers, & Chabrol, 2010). There is significant psychological/psychiatric morbidity associated with infant loss (Blackmore et al., 2011); however , only a few studies have investigated attachment styles and psychological trauma in response to both peri-and post-natal mortality. The primary aim of the current study was to identify attachment styles, or ''classes,'' based on individuals' relationship with their family members, romantic partners, and close friends. "
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    • "The labor, birth, and postpartum periods of women who experience stillbirth are physically similar to those of women who give birth to live, healthy babies; however, the negative effects are significantly greater [4]. Consequently, stillbirth presents a threefold increased risk of postpartum depression when compared with live, healthy births [5,6], and symptoms (e.g., perceived stress, anxiety, and sleep quality) may last for years or decades [1,4,6]. Depression may contribute to health problems, including weight retention or gain, increased risk of chronic disease (e.g., heart disease, diabetes), premature mortality, and poor quality of life [7,8]. "
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    BMC Pregnancy and Childbirth 01/2014; 14(1):26. DOI:10.1186/1471-2393-14-26 · 2.19 Impact Factor
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