Miscarriages can have lasting psychological effects on those concerned. In a prospective longitudinal study, 342 women were questioned about the way in which they coped after an early miscarriage (up to the 16th week of gestation), a few weeks after the pregnancy loss. There are data available from the first trimester of a subsequent pregnancy for 108 of these women. Standardized symptom scales were used to explore the pregnancy-specific anxiety, state and trait anxiety (STAI) and depressive symptoms in pregnant women and these were compared with the symptoms of 69 pregnant women with no history of miscarriages. Women with a history of miscarriages suffer more from pregnancy-specific anxieties in the first trimester of a new pregnancy than pregnant women with no history of miscarriages. Patterns of "depressive coping" and "anxious grieving" after the losses are predictive of more marked anxiety and depression symptoms in the first trimester of a subsequent pregnancy. These results suggest that women who have had an early miscarriage are particularly at risk of disturbances in their psychological adaptation in a new pregnancy. It is possible to determine risk factors which can be used to recognize those women who are particularly at risk directly after the miscarriage.

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A few weeks after miscarriage 232 women were questioned with standardized questionnaires and symptom scales about the way in which they coped with an early miscarriage (up to the 16th week of gestation) about mourning processes and subjective attribution as well as anamnestic and psychosocial characteristics. Seven and fourteen months after pregnancy loss and if necessary in the first trimester of a following pregnancy the psychological symptoms of the women (fear and depressive symptoms) were evaluated. A few weeks after miscarriage we found with main component analysis three patterns of coping. The pattern of "depressive coping" could be diagnosed as a predictor of increased depression seven months after the miscarriage and in a new pregnancy. Depressive pathology in a new pregnancy of the women with early pregnancy loss can be predicted also over the pattern of "anxious grieving". On the other hand, the pattern of "active coping" is associated with lower state anxiety in a new pregnancy. Lack of perceived partner support and past divorces or separations are risk factors for increased fears in a new pregnancy. These results suggest that women who have had an early miscarriage especially if they have maladaptive coping patterns and psychosocial risk factor for maladjustment need prevention of psychological disturbances with an integrated psychosomatic concept.

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