Network Analysis and Comparison of Psychological Distress Among Women With Miscarriage Experience

Abstract

BackgroundMiscarriage remains a considerable concern for women with as many as 15-25% of pregnancies not ending in a live birth. This experience has been robustly associated with negative impacts on health and well-being, however much of the extant evidence focuses on psychological pathologies. Adopting a more holistic approach, this study sought to examine the distress of women experiencing miscarriage following management at home, or in hospital.MethodologyThe current study used Network Analysis to examine associations between indicators of distress as measured by the Revised Impact of Miscarriage Scale (RIMS), e.g. feelings of loss, isolation, and devastation. The most influential or central distress indicators were assessed for the total sample of women who experience a miscarriage in the previous 5 years living in the UK (N = 839), and for subsamples of women who experienced miscarriage at home (n = 493), or in hospital (n = 273) comparing the networks of associated distress indicators for these groups.ResultsThese results suggested “feelings of a person lost”, a “destroyed zest for life” and “feelings of isolation” as the most central distress indicators in the impact of miscarriage network. These were therefore considered to influence the wider network of distress, including those of different domains within the RIMS. Comparisons between those who experienced miscarriage at home and in hospital revealed similar distress network structures, however those who experienced miscarriage at home displayed greater associations between distress indicators in the network.ConclusionThose most influential distress indicators are highlighted as important targets for screening psychological distress following miscarriage, and as potentially viable intervention targets to promote greater well-being among women experiencing miscarriage. These findings provide a novel understanding of psychological distress following miscarriage as a system of connected symptoms, further research is called for to examine the broader potential influences of the impact of miscarriage network.