Article

Previous prenatal loss 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: 7.34). 03/2011; 198(5):373-8. DOI: 10.1192/bjp.bp.110.083105
Source: PubMed

ABSTRACT 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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    • "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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    • "Others found 25% of bereaved couples had at least one distressed partner 30 months after a baby's death (Vance et al., 2002). Depression and anxiety after loss may continue for years, even after subsequently giving birth to a healthy infant (Blackmore et al., 2011). Two thirds of parents whose babies died of SIDS felt the death still affected them 12 to 15 years later and that few of their friends or associates knew their grief continued (Dyregrov & Dyregrov, 1999). "
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