Sadness may endure after miscarriage
U. ROCHESTER (US) — Women who suffer a miscarriage may experience depression for years, even after the birth of a healthy child.
Pregnancy loss by miscarriage or stillbirth affects more than an estimated one million women in the United States annually. Between 50 and 80 percent of women who experience pregnancy loss become pregnant again.
“Our study clearly shows that the birth of a healthy baby does not resolve the mental health problems that many women experience after a miscarriage or stillbirth,” says Emma Robertson Blackmore, assistant professor of psychiatry at the University of Rochester.
“This finding is important because, when assessing if a women is at risk of antenatal or postnatal depression, previous pregnancy loss is usually not taken into account in the same way as other risk factors such as a family history of depression, stressful life events, or a lack of social support.”
“We know that maternal depression can have adverse impacts on children and families,” Robertson Blackmore says. “If we offer targeted support during pregnancy to women who have previously lost a baby, we may be able to improve health outcomes for both the women and their children.”
Details of the study are published online in the British Journal of Psychiatry.
The researchers studied 13,133 pregnant women in the United Kingdom who were taking part in a long-term study known as the Avon Longitudinal Study of Parents and Children.
The women were asked to report the number of previous miscarriages and stillbirths they had experienced and were assessed for symptoms of depression and anxiety twice during their pregnancy and four times after giving birth, at 8 weeks, 8 months, 21 months, and 33 months.
The majority of women reported no miscarriages. But 2,823 women, or 21 percent, reported having one or more previous miscarriages, while 108 reported having one previous stillbirth and three women had two previous stillbirths.
“We found no evidence that affective symptoms associated with previous prenatal loss resolve with the birth of a healthy child. Rather, previous prenatal loss showed a persisting prediction of depressive and anxiety symptoms well after what would conventionally be defined as the postnatal period,” researchers say.
Of the women who had one miscarriage or stillbirth before giving birth to a healthy child, for example, almost 13 percent still had symptoms of depression 33 months after the birth. Of those with two previous losses, almost 19 percent had symptoms of depression 33 months after the birth of a healthy child.
Prenatal loss is not routinely considered a risk factor for antenatal or postpartum depression in the same way as, for instance, personal or family history of depression, exposure to stressful life events, or lack of social support.
Routinely assessing loss history would be valuable as a predictor of current and postpartum risk and as a possible marker for intervention, the researcher.
“Given the adverse outcomes of persistent maternal depression on both child and family outcomes, early recognition of symptoms can lead to preventive interventions to reduce the burden of illness, provide coping strategies to reduce anxiety and depression and promote healthy adjustment of the mother, family and child.”
Researchers from the Imperial College School of Medicine in London, and the University of Bristol, U.K. contributed to the study, that received funding from the National Institute of Mental Health and the Wellcome Trust.
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