Are Past Adverse Pregnancy Outcomes Associated with Maternal Anxiety and Depressive Symptoms in a Sample of Currently Pregnant Women?

Abstract

BACKGROUND: There has been a great deal of concern aboutthe mental health of women whose pregnancies involvemiscarriage, termination of a pregnancy (ToP), child death orwhere a child has been given up for adoption. Despite this concernthere has been remarkably little population-based research whichhas addressed the long-term consequences of pregnancy loss andchild death. This study investigated the maternal mental healthconsequences of women whose pregnancies involve miscarriage,ToP, child death or where a child has been given up for adoption attwo different time points, adjusting for socio-demographiccharacteristics and baseline mental health.METHODS: The Mater-University of Queensland Study ofPregnancy is a prospective pre-birth cohort study. Women wererecruited early in pregnancy over the period 1981 to 1983 at theirfirst antenatal clinic visit (FCV). Women were interviewed again atthe 14-year follow-up. Data from 4403 mothers were analysedusing maternal reports of a prior history of giving a child up foradoption, miscarriage, ToP, and neonatal, infant and/or childdeaths. Symptoms of maternal anxiety and depression weremeasured at FCV and the 14-year follow-up using the Delusions-Symptoms-States Inventory. We carried out logistic regressionanalysis using Stata 13. Odds ratios (ORs) with 95% confidenceintervals (CIs) were used to display the findings.RESULTS: A prior miscarriage was associated with anxiety(adjusted OR (AOR) = 1.30; 95% CI: 1.10-1.66) and depressive(AOR = 1.70; 95% CI: 1.21-2.39) symptoms at the 14-year follow-up. Having had a neonatal, infant and/or child deaths wasassociated with symptoms of depression at 14-year follow-up (AOR= 2.12; 95% CI: 1.06-4.25).CONCLUSION: The period after a child loss which involves a newpregnancy may be associated with relatively good mental healthdespite the fact that some mothers have experienced previousadverse pregnancy outcomes.