Our objective was to test the hypothesis that nulliparous women with a history of miscarriage have an increased risk of depression during late pregnancy, and at 1, 6, and 12 months postpartum compared to women without a history of miscarriage. We conducted secondary analysis of a longitudinal cohort study, the First Baby Study, and compared 448 pregnant women with a history of miscarriage to 2,343 pregnant women without a history of miscarriage on risk of probable depression (score >12 on the Edinburgh Postnatal Depression Scale). Logistic regression models were used to estimate odds ratios at each time point and generalized estimating equations were used to obtain estimates in longitudinal analysis. Women with a history of miscarriage were not more likely than woman without a history of miscarriage to score in the probable depression range during the third trimester or at 6 or 12 months postpartum but were more likely at 1 month postpartum, after adjustment for sociodemographic factors (OR 1.66, 95 % CI 1.03–2.69). Women with a history of miscarriage may be more vulnerable to depression during the first month postpartum than women without prior miscarriage, but this effect does not appear to persist beyond this time period. We support the promotion of awareness surrounding this issue and recommend that research is planned to identify risk factors that may position a woman with a history of miscarriage to be at higher risk for depression.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Zegers-Hochschild, F., Adamson, G., de Mouzon, J., Ishihara, O., Mansour, R., Nygren, K., et al. (2009). International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertility and Sterility, 92(5), 1520–1524.
Brier, N. (2008). Grief following miscarriage: A comprehensive review of the literature. Journal of Women’s Health, 17(3), 451–464.
Scotchie, J., & Fritz, M. (2006). Early pregnancy loss. Postgraduate Obstetrics and Gynecology, 26(9), 1–7.
Cuisinier, M., Janssen, H., de Graauw, C., Bakker, S., & Hoogduin, C. (1996). Pregnancy following miscarriage: Course of grief and some determining factors. Journal of Psychosomatic Obstetrics and Gynecology, 17, 168–174.
Armstrong, D. (2002). Emotional distress and prenatal attachment in pregnancy after perinatal loss. Journal of Nursing Scholarship, 34(4), 339–345.
Franche, R., & Mikail, S. (1999). The impact of perinatal loss on adjustment to subsequent pregnancy. Social Science Medicine, 48(11), 1613–1623.
Lamb, E. H. (2002). The impact of previous perinatal loss on subsequent pregnancy and parenting. The Journal of Perinatal Education, 11(2), 33–40.
Armstrong, D. (2004). Impact of prior perinatal loss on subsequent pregnancies. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(6), 765–773.
Blackmore, E. R., Cote-Arsenault, D., Tang, W., Glover, V., Evans, J., Golding, J., et al. (2011). Previous prenatal loss as a predictor of perinatal depression and anxiety. British Journal of Psychiatry, 198(5), 373–378.
Yilmaz, S. D., & Beji, N. K. (2013). Effects of perinatal loss on current pregnancy in Turkey. Midwifery, 29(11), 1272–1277.
Gong, X., Hao, J., Tao, F., Zhang, J., Wang, H., & Xu, R. (2013). Pregnancy loss and anxiety and depression during subsequent pregnancies: Data from the C-ABC study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 166(1), 30–36.
Hughes, P., Turton, P., & Evans, C. D. (1999). Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: Cohort study. BMJ, 318(7200), 1721–1724.
Couto, E. R., Couto, E., Vian, B., Gregorio, Z., Nomura, M. L., Zaccaria, R., et al. (2009). Quality of life, depression and anxiety among pregnant women with previous adverse pregnancy outcomes. Sao Paulo Medical Journal, 127(4), 185–189.
Cote-Arsenault, D. (2007). Threat appraisal, coping, and emotions across pregnancy subsequent to perinatal loss. Nursing Research, 56(2), 108–116.
Cote-Arsenault, D., Bidlack, D., & Humm, A. (2001). Women’s emotions and concerns during pregnancy following perinatal loss. MCN: American Journal of Maternal Child Nursing, 26(3), 128–134.
Armstrong, D. (2007). Perinatal loss and parental distress after the birth of a healthy infant. Advances in Neonatal Care, 7(4), 200–206.
Gaudet, C., Sejourne, N., Camborieux, L., Rogers, R., & Chabrol, H. (2010). Pregnancy after perinatal loss: Association of grief, anxiety, and attachment. Journal of Reproductive and Infant Psychology, 28(3), 240–251.
Theut, S. K., Pedersen, F. A., Zaslow, M. J., & Rabinovich, B. A. (1988). Pregnancy subsequent to perinatal loss: Parental anxiety and depression. Journal of the American Academy of Child and Adolescent Psychiatry, 27(3), 289–292.
Hutti, M. H., Armstrong, D. S., & Myers, J. (2011). Healthcare utilization in the pregnancy following a perinatal loss. MCN: American Journal of Maternal Child Nursing, 36(2), 104–111.
Wheeler, S. R., & Austin, J. (2000). The loss response list: A tool for measuring adolescent grief responses. Death Studies, 24(1), 21–34.
Bergner, A., Beyer, R., Klapp, B. F., & Rauchfuss, M. (2008). Pregnancy after early pregnancy loss: A prospective study of anxiety, depressive symptomatology and coping. Journal of Psychosomatic Obstetrics and Gynaecology, 29(2), 105–113.
Marcinko, V. M., Marcinko, D., Dordevic, V., & Oreskovic, S. (2011). Anxiety and depression in pregnant women with previous history of spontaneous abortion. Collegium Antropologicum, 35(Suppl 1), 225–228.
Hamama, L., Rauch, S. A., Sperlich, M., Defever, E., & Seng, J. S. (2010). Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancy. Depression and Anxiety, 27(8), 699–707.
Armstrong, D., Hutti, M., & Myers, J. (2009). The influence of prior perinatal loss on parents’ psychological distress after the birth of a subsequent healthy infant. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38, 654–666.
Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67(10), 1012–1024.
Diego, M. A., Jones, N. A., Field, T., Hernandez-Reif, M., Schanberg, S., Kuhn, C., et al. (2006). Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosomatic Medicine, 68(5), 747–753.
APA. (2010). American Psychiatric Association DSM-V Development. http://www.dsm5.org/Pages/Default.aspx.
Beck, C. T. (2002). Postpartum depression: A metasynthesis. Qualitative Health Research, 12(4), 453–472.
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.
NICHD Early Child Care Research Network. (1999). Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. Developmental Psychology, 35(5), 1297–1310.
Kjerulff, K. H., Velott, D. L., Zhu, J., Chuang, C. H., Hillemeier, M. M., Paul, I. M., et al. (2013). Mode of first delivery and women’s intentions for subsequent childbearing: Findings from the First Baby Study. Paediatric and Perinatal Epidemiology, 27(1), 62–71.
Bicking Kinsey, C., Baptiste-Roberts, K., Zhu, J., & Kjerulff, K. (2013). Effect of previous miscarriage on the maternal birth experience in the First Baby Study. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 42(4), 442–450.
Misra, D. P., O’Campo, P., & Strobino, D. (2001). Testing a sociomedical model for preterm delivery. Paediatric and Perinatal Epidemiology, 15(2), 110–122.
Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782–786.
Gibson, J., McKenzie-McHarg, K., Shakespeare, J., Price, J., & Gray, R. (2009). A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatrica Scand., 119(5), 350–364.
Carrera, L., Diez-Domingo, J., Montanana, V., Monleon Sancho, J., Minguez, J., & Monleon, J. (1998). Depression in women suffering perinatal loss. International Journal of Gynaecology and Obstetrics, 62(2), 149–153.
Price, S. (2008). Stepping back to gain perspective: Pregnancy loss history, depression, and parenting capacity in the early childhood longitudinal study, birth cohort (ECLS-B). Death Studies, 32(2), 97–122.
Le Strat, Y., Dubertret, C., & Le Foll, B. (2011). Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. Journal of Affective Disorders, 135(1–3), 128–138.
Witt, W. P., DeLeire, T., Hagen, E. W., Wichmann, M. A., Wisk, L. E., Spear, H. A., et al. (2010). The prevalence and determinants of antepartum mental health problems among women in the USA: A nationally representative population-based study. Archives of Women’s Mental Health, 13(5), 425–437.
Witt, W. P., Wisk, L. E., Cheng, E. R., Hampton, J. M., Creswell, P. D., Hagen, E. W., et al. (2011). Poor prepregnancy and antepartum mental health predicts postpartum mental health problems among US women: A nationally representative population-based study. Womens Health Issues, 21(4), 304–313.
Edhborg, M., Nasreen, H. E., & Kabir, Z. N. (2011). Impact of postpartum depressive and anxiety symptoms on mothers’ emotional tie to their infants 2–3 months postpartum: A population-based study from rural Bangladesh. Archives of Women’s Mental Health, 14(4), 307–316.
Taylor, A., Atkins, R., Kumar, R., Adams, D., & Glover, V. (2005). A new Mother-to-Infant Bonding Scale: Links with early maternal mood. Archives of Women’s Mental Health, 8(1), 45–51.
Reck, C., Klier, C., Pabst, K., Stehle, E., Steffenelli, U., Struben, K., et al. (2006). The German version of the Postpartum Bonding Instrument: Psychometric properties and association with postpartum depression. Archives of Women’s Mental Health, 9, 265–271.
Moehler, E., Brunner, R., Wiebel, A., Reck, C., & Resch, F. (2006). Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother–child bonding. Archives of Women’s Mental Health, 9(5), 273–278.
Siu, B. W., Ip, P., Chow, H. M., Kwok, S. S., Li, O. L., Koo, M. L., et al. (2010). Impairment of mother–infant relationship: Validation of the Chinese version of Postpartum Bonding Questionnaire. The Journal of Nervous and Mental Disease, 198(3), 174–179.
Edhborg, M., & Lundh, W. (2005). Some early indicators for depressive symptoms and bonding 2 months postpartum—A study of new mothers and fathers. Archives of Women’s Mental Health, 8(4), 221–231.
Deave, T., Heron, J., Evans, J., & Emond, A. (2008). The impact of maternal depression in pregnancy on early child development. BJOG, 115(8), 1043–1051.
Diego, M. A., Field, T., Hernandez-Reif, M., Cullen, C., Schanberg, S., & Kuhn, C. (2004). Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry, 67(1), 63–80.
Field, T., Diego, M., & Hernandez-Reif, M. (2009). Depressed mothers’ infants are less responsive to faces and voices. Infant Behavior and Development, 32(3), 239–244.
Luoma, I., Kaukonen, P., Mantymaa, M., Puura, K., Tamminen, T., & Salmelin, R. (2004). A longitudinal study of maternal depressive symptoms, negative expectations and perceptions of child problems. Child Psychiatry and Human Development, 35(1), 37–53.
Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., et al. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1367–1374.
Milgrom, J., Westley, D. T., & McCloud, P. I. (1995). Do infants of depressed mothers cry more than other infants? Journal of Paediatrics and Child Health, 31(3), 218–221.
O’Connor, T. G., Caprariello, P., Blackmore, E. R., Gregory, A. M., Glover, V., & Fleming, P. (2007). Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood. Early Human Development, 83(7), 451–458.
This study was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R01 HD052990). KHK is the principal investigator for this award. CBK was also supported by a fellowship from the National Institute for Nursing Research (F31 NR013303) and by the Eastern Nursing Research Society and the Council for the Advancement of Nursing Science.
Rights and permissions
About this article
Cite this article
Bicking Kinsey, C., Baptiste-Roberts, K., Zhu, J. et al. Effect of Previous Miscarriage on Depressive Symptoms During Subsequent Pregnancy and Postpartum in the First Baby Study. Matern Child Health J 19, 391–400 (2015). https://doi.org/10.1007/s10995-014-1521-0
- Perinatal loss
- Perinatal depression
- Postpartum depression