Mental health effects of early pregnancy loss linger for months

  • Am J Obstet Gynecol

  • de Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Post-traumatic stress disorder (PTSD), anxiety, and depression are common for up to 9 months after early pregnancy loss.

Why this matters

  • More than 250,000 miscarriages and 10,000 ectopic pregnancies occur annually in the UK.
  • The psychological consequences of miscarriage and ectopic pregnancy are not well characterized.

Key results

  • Prevalence of morbidity at 1 month after early pregnancy loss:
    • PTSD, 29%.
    • Moderate/severe anxiety, 24%.
      • aOR, 2.14 (95% CI, 1.14-4.36).
    • Moderate/severe depression, 11%.
      • aOR, 3.88 (95% CI, 1.27-19.2).
  • The prevalence of each disorder declined over time:
    • PTSD: 21% at 3 months vs 18% at 9 months.
    • Moderate /severe anxiety: 23% vs 17%.
    • Moderate/severe depression: 8% vs 6%.
  • Evolution of morbidity was no different between ectopic pregnancy and miscarriage (PTSD, P=.43; anxiety, P=.14; depression, P=.07).

Study design

  • The prospective multicenter Psychological Impact of Early Pregnancy Events cohort study.
  • Longitudinal assessment of psychological morbidity in women after early pregnancy loss (n=1201) compared with controls (n=195).
  • Participants were recruited from 3 early pregnancy assessment units in London.
  • Participants were asked to complete a survey sent by email.
  • The Hospital Anxiety and Depression Scale and the Post-traumatic Stress Diagnostic Scale used to assess morbidity.
  • Funding: Individual author support only.

Limitations

  • High drop-out rate.