Exploring the impact of prior spontaneous miscarriage on stress among pregnant women during the first trimester: an observational study

Abstract

BackgroundSpontaneous miscarriage is the most common complication of pregnancy. Its psychological repercussions are widely documented but few studies have investigated its effect on the woman’s experience of a subsequent pregnancy.AimTo evaluate the impact of prior spontaneous miscarriage on the level of stress experienced by pregnant women during the first trimester of pregnancy.Design and settingCross-sectional, observational study between June and October 2021 in France.MethodA self-report questionnaire was distributed to women in the first trimester of pregnancy. Stress was assessed using the Antenatal Perceived Stress Inventory, to yield an overall score, and a score for three dimensions (medical and obstetric risks/fetal health; psychosocial changes; and the prospect of childbirth). Women with a history of prior spontaneous miscarriage and those without were compared.Results93 women were included ; 63 without and 30 with a history of prior spontaneous miscarriage. Prior spontaneous miscarriage was not associated with the overall score. The score for the dimension “medical and obstetric risks/fetal health” was significantly higher in women with prior spontaneous miscarriage (3.00±0.86 vs 2.34±0.80 ;β=0.61 (0.25–0.96) ;P=0.001). Prior spontaneous miscarriage was significantly associated with the items “the baby’s health” (P=0.048) and “the echography” (P=0.002).ConclusionThis study shows a significant impact of prior spontaneous miscarriage on the level of stress of pregnant women during the first trimester, particularly relating to the medical and obstetric risks/fetal health, underlining the need for appropriate psychological support to be provided to women who experience spontaneous miscarriage.

Utility of early, short psychological care for women who experience early miscarriage: protocol for the randomized, controlled MisTher trial

“…Fertl et al reported that women who had a history of spontaneous pregnancy loss had higher levels of anxiety during the first trimester of subsequent pregnancy, compared to women with no history of miscarriage [21]. In a French study by Barbe et al, it was found that during the first trimester of pregnancy, women with a history of spontaneous miscarriage had higher stress levels relating to the medical and obstetric risks or fetal health, than women with no history of miscarriage [22]. Similarly, Haghparast et al showed that pregnant women who had a history of spontaneous abortion during the previous year had higher scores on anxiety and depression scales (amongst others) compared to pregnant women without a history of spontaneous abortion [23].…”