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Title: Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy
Authors: McCarthy, F. P.
Moss-Morris, R.
Khashan, A. S.
North, R. A.
Baker, Philip Newton
Dekker, G.
Poston, L.
McCowan, L.
Walker, J. J.
Kenny, L. C.
O'Donoghue, K.
First Published: 6-Jan-2015
Publisher: Wiley, Royal College of Ostetricians and Gynaecologist (RCOG)
Citation: BJOG, 2015, 122 (13), pp. 1757-1764
Abstract: OBJECTIVE: To investigate whether women with previous miscarriages or terminations have higher levels of anxiety, depression, stress, and altered behaviours in a subsequent pregnancy. DESIGN: A retrospective analysis of 5575 women recruited into the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study. SETTING: Auckland, New Zealand, Adelaide, Australia, Cork, Ireland, and Manchester, Leeds, and London, UK. POPULATION: Healthy nulliparous women with singleton pregnancies. METHODS: Outcomes were recorded at 15 and 20 weeks of gestation. MAIN OUTCOME MEASURES: Short-form State-Trait Anxiety Inventory (STAI) score, Perceived Stress Scale score, Edinburgh Postnatal Depression Scale score, and pregnancy-related behaviour measured using behavioural responses to pregnancy score. RESULTS: Of the 5465 women included in the final analysis, 559 (10%) had one and 94 (2%) had two previous miscarriages, and 415 (8%) had one and 66 (1%) had two previous terminations of pregnancy. Women with one previous miscarriage had increased anxiety (adjusted mean difference 1.85; 95% confidence interval, 95% CI 0.61-3.09), perceived stress (adjusted mean difference 0.76; 95% CI 0.48-1.03), depression (adjusted odds ratio, aOR 1.26; 95% CI 1.08-1.45), and limiting/resting behaviour in pregnancy (adjusted mean difference 0.80; 95% CI 0.62-0.97). In women with two miscarriages, depression was more common (aOR 1.65; 95% CI 1.01-2.70) and they had higher scores for limiting/resting behaviour in pregnancy (adjusted mean difference 1.70; 95% CI 0.90-2.53) at 15 weeks of gestation. Women with one previous termination displayed elevated perceived stress (adjusted mean difference 0.65; 95% CI 0.08-1.23) and depression (aOR 1.25; 95% 1.08-1.45) at 15 weeks of gestation. Women with two previous terminations displayed increased perceived stress (adjusted mean difference 1.43; 95% CI 0.00-2.87) and depression (aOR 1.67; 95% 1.28-2.18). CONCLUSIONS: This study highlights the psychological implications of miscarriage and termination of pregnancy.
DOI Link: 10.1111/1471-0528.13233
ISSN: 1470-0328
eISSN: 1471-0528
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2015 Royal College of Obstetricians and Gynaecologists. This is the peer reviewed version of the following article: McCarthy FP, Moss-Morris R, Khashan AS, North RA, Baker PN, Dekker G, Poston L, McCowan LME, Walker JJ, Kenny LC, O'Donoghue K. Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. BJOG 2015;122:1757–1764, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Appears in Collections:Published Articles, College of Medicine, Biological Sciences and Psychology

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