Threat Appraisal, Coping, and Emotions Across Pregnancy Subsequent to Perinatal Loss

Côté‐Arsenault, Denise

doi:10.1097/01.nnr.0000263970.08878.87

Cited by 85 publications

(80 citation statements)

References 21 publications

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“…While a new pregnancy is often a positive event, for bereaved parents, this also raises the specter of a repeat loss, and qualitative work has demonstrated intense anxiety and increased depressive symptoms among perinatally-bereaved women in subsequent pregnancies. 19,[33][34][35] However, many of these studies have been cohort studies of bereaved women and have not included a control group of women with live birth. In addition, most have used convenience sampling.…”

Section: Main Findingsmentioning

confidence: 99%

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Gold

Leon

Boggs

et al. 2016

Journal of Women's Health

110

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Introduction: Perinatal loss is often a traumatic outcome for families. While there are limited data about depressive outcomes in small populations, information about depression and posttraumatic stress disorder among large racially and economically diverse populations is sparse. Methods: We collaborated with the Michigan Department of Community Health to conduct a longitudinal survey of bereaved mothers with stillbirth or infant death under 28 days of life and live-birth (control) mothers in Michigan. The study assessed 9-month mental health outcomes including self-reported symptoms of depression and posttraumatic stress disorder along with information about demographics, pregnancy and loss experience, social support, and past and present mental health and treatment. Results: Of 1400 women contacted by the State of Michigan, 609 completed surveys and were eligible to participate for a 44% response rate (377 bereaved mothers and 232 control mothers with live births). In multivariable analysis, bereaved women had nearly 4-fold higher odds of having a positive screen for depression and 7-fold higher odds of a positive screen for post-traumatic stress disorder after controlling for demographic and personal risk variables. A minority of screen-positive women were receiving any type of psychiatric treatment. Conclusion: This is the largest epidemiologically based study to date to measure the psychological impact of perinatal loss. Nine months after a loss, bereaved women showed high levels of distress with limited rates of treatment. Symptoms need to be monitored over time for persisting disorder and further research should identify women at highest risk for poor outcomes.

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Section: Main Findingsmentioning

confidence: 99%

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Gold

Leon

Boggs

et al. 2016

Journal of Women's Health

110

View full text Add to dashboard Cite

show abstract

“…4,[7][8][9][10][11][12][13][14][15] Some women also experience guilt, anger, posttraumatic stress, and anxiety about future childbearing. [16][17][18][19] Six months after miscarrying, women who are most depressed are least likely to have partners willing to talk about the miscarriage. 5 Most women wish to discuss pregnancy loss and share it with their partners, 20,21 yet 85% of couples share their feelings to a limited degree, if at all.…”

Section: Introductionmentioning

confidence: 99%

Resolution of Depression and Grief during the First Year after Miscarriage: A Randomized Controlled Clinical Trial of Couples-Focused Interventions

Swanson

Chen

Graham

et al. 2009

Journal of Women's Health

107

105

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Aims: The purpose of this randomized controlled clinical trial was to examine the effects of three couplesfocused interventions and a control condition on women and men's resolution of depression and grief during the first year after miscarriage. Methods: Three hundred forty-one couples were randomly assigned to nurse caring (NC) (three counseling sessions), self-caring (SC) (three video and workbook modules), combined caring (CC) (one counseling session plus three SC modules), or control (no treatment). Interventions, based on Swanson's Caring Theory and Meaning of Miscarriage Model, were offered 1, 5, and 11 weeks after enrollment. Outcomes included depression (CES-D) and grief, pure grief (PG) and grief-related emotions (GRE). Differences in rates of recovery were estimated via multilevel modeling conducted in a Bayesian framework. Results: Bayesian odds (BO) ranging from 3.0 to 7.9 favored NC over all other conditions for accelerating women's resolution of depression. BO of 3.2-6.6 favored NC and no treatment over SC and CC for resolving men's depression. BO of 3.1-7.0 favored all three interventions over no treatment for accelerating women's PG resolution, and BO of 18.7-22.6 favored NC and CC over SC or no treatment for resolving men's PG. BO ranging from 2.4 to 6.1 favored NC and SC over CC or no treatment for hastening women's resolution of GRE. BO from 3.5 to 17.9 favored NC, CC, and control over SC for resolving men's GRE. Conclusions: NC had the overall broadest positive impact on couples' resolution of grief and depression. In addition, grief resolution (PG and GRE) was accelerated by SC for women and CC for men.

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“…A percentage of these pregnancies will unfortunately terminate in miscarriage [1] and these women may become pregnant again [2] while carrying with them their misgivings of their earlier loss [3,4]. The percentage of miscarriages from a Scandinavian study is approximately 15% -20% of all pregnancies [5,6] and in Sweden one in every four women who give birth state that they have experienced one or more miscarriages [2].…”

Section: Introductionmentioning

confidence: 99%

Swedish Women’S Emotional Experience of the First Trimester in a New Pregnancy after One or More Miscarriages: A Qualitative Interview Study

Adolfsson¹,

Johansson²,

Nilsson³

2012

ASM

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Objectives: The aim of this study was to evaluate how Swedish women describe their emotional state of being during the eighth week through the eleventh week after they have become pregnant again after suffering a previous miscarriage. Method: A qualitative content analysis with an inductive approach has been used to analyze fourteen interviews that served as the data base for this study. The content analysis resulted in the development of five categories which evolved into one primary theme. Findings: The five categories identified were Worry and preoccupation; Distance; managing their feelings; Mourning what is lost; Guarded happiness and expectations. These categories were compiled into a main theme, "Worry consumes a lot of energy, but on the other side lies happiness". This theme focused on whether the women could feel any happiness about being pregnant again despite their concerns with the previous miscarriage. Conclusions: The emotional states of the women when they get pregnant again are typically characterized by anxiety, worry and concerns about their current pregnancy. The women have a tendency to distance themselves emotionally from their pregnancy but also strive to find the joy of being pregnant again. During the new pregnancy they find themselves in need of support from their family and friends as well as in need of support from the healthcare system.

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Threat Appraisal, Coping, and Emotions Across Pregnancy Subsequent to Perinatal Loss

Abstract: Women find pregnancy after loss stressful and a threat, and this appraisal remains across pregnancy. Because pregnancy anxiety is common, and highest in early pregnancy, providers should address worries and fears with all women early in PAL. Interventions must be tested in future studies.

Cited by 85 publications

References 21 publications

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample

Resolution of Depression and Grief during the First Year after Miscarriage: A Randomized Controlled Clinical Trial of Couples-Focused Interventions

Swedish Women’S Emotional Experience of the First Trimester in a New Pregnancy after One or More Miscarriages: A Qualitative Interview Study

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