Postnatal Depression and Post-traumatic Stress Risk following Miscarriage

Abstract

Introduction. The experience of miscarriage is an important population-level problem, which affects ~10-25% of pregnancies [1-2]. The physical consequences of miscarriage are quite well appreciated, yet psychological sequelae less so [3]. First person accounts show that women who experience miscarriage feel pressured to stay silent, grief, and fight intense physical and psychological challenges alone [1, 3]. There is ample scientific evidence on the links between miscarriage and physical, as well as mental health disorders, such as complicated grief, anxiety, depression, post-traumatic stress, suicidal risk, psychosomatic disorders, sexual health disorders, etc. [3-10]. Distress tends to remain at clinically important levels up to 9 months or more [7-8]. This study aimed to assess the risk of post-traumatic stress and postnatal depression following miscarriage. Methods. 839 Lithuanian womwn who had one or more miscarriages completed an online survey, including Impact of Events scale-Revised (IES-R) and Edinburgh Postnatal Depression Scale (EPDS). Results. Assessments of physical and emotional well-being after miscarriage differed significantly. Emotional well-being was assessed 1.5-2 times worse than physical. 59.1% of women were at risk of postnatal depression and 44.7% - of post-traumatic stress. In binary logistic analysis, worsened relationship with one’s body after miscarriage was the strongest predictor to an increased postnatal depression risk (OR=2.48, CI[1.78, 3.44]). Younger age, no higher education, worse emotional well-being before pregnancy, worse physical and emotional well-being immediately after miscarriage, and less support from family and close friends were also associated with an in increased postnatal depression risk. Not having children (OR=2.45, CI[1.60, 3.73]) and worsened relationship with one’s body (OR=2.00, CI[1.46, 2.75]) were the strongest predictors to an increased post-traumatic stress risk. Recurrent miscarriages as well as physical well-being immediately after miscarriage, emotional well-being immediately after miscarriage, and less support from family and close friends were also associated with an increase in the likelihood of post-traumatic stress.[...].