Previous prenatal loss as a predictor of perinatal depression and anxiety

  1. Emma Robertson Blackmore, PhD
  1. Department of Psychiatry, University of Rochester Medical Center, New York
  1. Denise Côté-Arsenault, PhD
  1. School of Nursing, University of Rochester Medical Center, New York
  1. Wan Tang, PhD
  1. Department of Biostatistics and Computational Biology, University of Rochester Medical Center, New York, USA
  1. Vivette Glover, PhD
  1. Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, London, UK
  1. Jonathan Evans, PhD
  1. Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol
  1. Jean Golding, PhD
  1. Centre for Child and Adolescent Health, University of Bristol, UK
  1. Thomas G. O’Connor, PhD
  1. Department of Psychiatry, University of Rochester Medical Center, New York, USA
  1. Correspondence: Emma Robertson Blackmore, PhD, University of Rochester Medical Center, BOX PSYCH 4-9200, 300 Crittenden Blvd, Rochester, NY 14642–8409, USA. Email: Emma_robertsonblackmore{at}urmc.rochester.edu
  • Declaration of interest

    None.

Abstract

Background

Prenatal loss, the death of a fetus/child through miscarriage or stillbirth, is associated with significant depression and anxiety, particularly in a subsequent pregnancy.

Aims

This study examined the degree to which symptoms of depression and anxiety associated with a previous loss persisted following a subsequent successful pregnancy.

Method

Data were derived from the Avon Longitudinal Study of Parents and Children cohort, a longitudinal cohort study in the west of England that has followed mothers from pregnancy into the postnatal period. A total of 13 133 mothers reported on the number and conditions of previous perinatal losses and provided self-report measures of depression and anxiety at 18 and 32 weeks’ gestation and at 8 weeks and 8, 21 and 33 months postnatally. Controls for pregnancy outcome and obstetric and psychosocial factors were included.

Results

Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P<0.01) and anxiety (β = 0.14, s.e. = 0.05, P<0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors. This association remained constant across the pre- and postnatal period, indicating that the impact of a previous prenatal loss did not diminish significantly following the birth of a healthy child.

Conclusions

Depression and anxiety associated with a previous prenatal loss shows a persisting pattern that continues after the birth of a subsequent (healthy) child. Interventions targeting women with previous prenatal loss may improve the health outcomes of women and their children.