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Effect of Previous Miscarriage on Depressive Symptoms During Subsequent Pregnancy and Postpartum in the First Baby Study

Abstract

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.

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References

  1. 1.

    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.

    CAS  PubMed  Article  Google Scholar 

  2. 2.

    Brier, N. (2008). Grief following miscarriage: A comprehensive review of the literature. Journal of Women’s Health, 17(3), 451–464.

    PubMed  Article  Google Scholar 

  3. 3.

    Scotchie, J., & Fritz, M. (2006). Early pregnancy loss. Postgraduate Obstetrics and Gynecology, 26(9), 1–7.

    Article  Google Scholar 

  4. 4.

    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.

    CAS  PubMed  Article  Google Scholar 

  5. 5.

    Armstrong, D. (2002). Emotional distress and prenatal attachment in pregnancy after perinatal loss. Journal of Nursing Scholarship, 34(4), 339–345.

    PubMed  Article  Google Scholar 

  6. 6.

    Franche, R., & Mikail, S. (1999). The impact of perinatal loss on adjustment to subsequent pregnancy. Social Science Medicine, 48(11), 1613–1623.

    CAS  PubMed  Article  Google Scholar 

  7. 7.

    Lamb, E. H. (2002). The impact of previous perinatal loss on subsequent pregnancy and parenting. The Journal of Perinatal Education, 11(2), 33–40.

    PubMed Central  PubMed  Google Scholar 

  8. 8.

    Armstrong, D. (2004). Impact of prior perinatal loss on subsequent pregnancies. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(6), 765–773.

    PubMed  Article  Google Scholar 

  9. 9.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  10. 10.

    Yilmaz, S. D., & Beji, N. K. (2013). Effects of perinatal loss on current pregnancy in Turkey. Midwifery, 29(11), 1272–1277.

    PubMed  Article  Google Scholar 

  11. 11.

    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.

    PubMed  Article  Google Scholar 

  12. 12.

    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.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  13. 13.

    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.

    PubMed  Article  Google Scholar 

  14. 14.

    Cote-Arsenault, D. (2007). Threat appraisal, coping, and emotions across pregnancy subsequent to perinatal loss. Nursing Research, 56(2), 108–116.

    PubMed  Article  Google Scholar 

  15. 15.

    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.

    CAS  PubMed  Google Scholar 

  16. 16.

    Armstrong, D. (2007). Perinatal loss and parental distress after the birth of a healthy infant. Advances in Neonatal Care, 7(4), 200–206.

    PubMed  Article  Google Scholar 

  17. 17.

    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.

    Article  Google Scholar 

  18. 18.

    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.

    CAS  PubMed  Article  Google Scholar 

  19. 19.

    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.

    PubMed  Google Scholar 

  20. 20.

    Wheeler, S. R., & Austin, J. (2000). The loss response list: A tool for measuring adolescent grief responses. Death Studies, 24(1), 21–34.

    CAS  PubMed  Article  Google Scholar 

  21. 21.

    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.

    PubMed  Article  Google Scholar 

  22. 22.

    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.

    PubMed  Google Scholar 

  23. 23.

    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.

    PubMed Central  PubMed  Google Scholar 

  24. 24.

    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.

    PubMed  Article  Google Scholar 

  25. 25.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  26. 26.

    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.

    PubMed  Article  Google Scholar 

  27. 27.

    APA. (2010). American Psychiatric Association DSM-V Development. http://www.dsm5.org/Pages/Default.aspx.

  28. 28.

    Beck, C. T. (2002). Postpartum depression: A metasynthesis. Qualitative Health Research, 12(4), 453–472.

    PubMed  Article  Google Scholar 

  29. 29.

    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.

    PubMed  Article  Google Scholar 

  30. 30.

    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.

    Article  Google Scholar 

  31. 31.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  32. 32.

    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.

    PubMed  Article  Google Scholar 

  33. 33.

    Misra, D. P., O’Campo, P., & Strobino, D. (2001). Testing a sociomedical model for preterm delivery. Paediatric and Perinatal Epidemiology, 15(2), 110–122.

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    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.

    CAS  PubMed  Article  Google Scholar 

  36. 36.

    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.

    CAS  Article  Google Scholar 

  37. 37.

    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.

    CAS  PubMed  Article  Google Scholar 

  38. 38.

    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.

    PubMed  Article  Google Scholar 

  39. 39.

    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.

    PubMed  Article  Google Scholar 

  40. 40.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  41. 41.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  42. 42.

    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.

    PubMed  Article  Google Scholar 

  43. 43.

    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.

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    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.

    CAS  PubMed  Article  Google Scholar 

  45. 45.

    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.

    CAS  PubMed  Article  Google Scholar 

  46. 46.

    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.

    PubMed  Article  Google Scholar 

  47. 47.

    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.

    CAS  PubMed  Article  Google Scholar 

  48. 48.

    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.

    CAS  PubMed  Article  Google Scholar 

  49. 49.

    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.

    PubMed  Google Scholar 

  50. 50.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

  51. 51.

    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.

    PubMed  Article  Google Scholar 

  52. 52.

    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.

    CAS  PubMed  Article  Google Scholar 

  53. 53.

    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.

    CAS  PubMed  Article  Google Scholar 

  54. 54.

    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.

    PubMed Central  PubMed  Article  Google Scholar 

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Acknowledgments

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.

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Correspondence to Cara Bicking Kinsey.

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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

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Keywords

  • Perinatal loss
  • Perinatal depression
  • Pregnancy
  • Postpartum depression
  • Miscarriage