Factors associated with a positive depression screen after a miscarriage

Abstract

IntroductionMiscarriages are a common pregnancy complication and positive depression screen after a miscarriage has been shown to be high in our population. Various factors are associated with an increased risk of developing depression after a miscarriage. However, these factors vary across populations studied with no studies existing in our region. We set out to determine the factors associated with a positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi.MethodsPatients were recruited at the 2 weeks clinic review after a miscarriage in the gynaecological clinics. They were screened using the Edinburgh postnatal depression scale for depression after a miscarriage. Analysis was done using Univariate and multivariate analysis to compare clinical variables between the screen - positive and screen - negative women in order to delineate the potential pattern of association between the two among the study subjects.ResultsPositive depression screen was detected in 34.1% of the patients recruited. Univariate analysis revealed that education level (p = 0.039) and mode of conception (p = 0.005) impacted on the outcome of the depression screen. In multivariate analysis, multiple factors impacted on the depression screen and these included: age (p = 0.009), education level (p = 0.001), gestation at miscarriage (p = 0.04), marital status (p = 0.043), prior miscarriage (p = 0.011) and mode of conception (p = 0.03).ConclusionFactors that seem to impact on the positive depression screen include a younger age, low education level, an older gestational age at miscarriage, being single, an assisted mode of conception and prior miscarriage. These factors may be used to triage women after a miscarriage in order to pick up those who may screen positive for depression after a miscarriage.

Psychological problem areas of pregnant women diagnosed with abortus imminens as a result of assisted reproductive techniques: A comparative study

“…In the literature, it has been reported that those who have an individual and family history of depression are more vulnerable to post‐abortion depression and have a higher risk of developing depression after abortion 34 . In our study, the depressive symptoms, anxiety, and hopelessness levels of the patients with an individual and family history of depression in the group with a diagnosis of TM were found to be high.…”

Risk of post-traumatic stress disorder in women after miscarriage

“…The risk of adverse psychological reactions after miscarriage is also significantly influenced by whether it was spontaneous or pharmacologically induced. A higher percentage of psychiatric complications was associated with the latter [27].…”

“…The literature reports that the rates of depression in women after miscarriage reach up to 55% [2,11,13,15,19,[24][25][26][27], anxiety from 28% to 45% both immediately after the event and even 6 months after it [12, 14-16, 20, 27, 28]. Interesting studies in this area were conducted by Neugebauer et al [13], who evaluated the mental well-being of women 2 and 6 weeks and 6 months after loss compared to women who were and women who were not pregnant.…”

“…Other data indicate that early pregnancy loss may be a predictive factor of postnatal depression [29]. Around one third of women who were positive for depression after miscarriage were also at increased risk of suicidal thoughts [27]. Moreover, a study in Finland showed that between 1987 and 1994 the average annual suicide rate in 1 year after miscarriage was significantly higher (18.1 per 100,000) than that of women in the general population (11.3) [14].…”

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

“…Moreover, couples had to face the cumulative effect of RPL with an increase in exhaustion and pressure exerted by the subsequent pregnancy losses. Almost a third and a fth of outpatients with RPL history are diagnosed as having depression and anxiety, respectively [3][4][5][6]. The maternal depression and anxiety problems after miscarriage possibly result in failure of the next pregnancy and adverse birth outcomes; however, the relevant literature is lacking in evidence to this effect [7][8][9][10][11].…”