Pregnancy after miscarriage in primiparae and multiparae: implications for women's psychological well-being

Dispositional mindfulness profiles in pregnant women: relationships with dyadic adjustment and symptoms of depression and anxiety

Introduction

Pregnancy is a time of major transition that can be stressful for women. Dispositional mindfulness may protect individuals when they face stress. Recent studies have adopted a person-centered approach to examine the role of mindfulness by identifying subtypes of individuals based on their scores in five mindfulness facets. Latent profile analysis was used to identify different mindfulness profiles in a sample of pregnant women, and we explored the relationships between these profiles, depression and anxiety symptoms, and whether dyadic adjustment mediated these relationships.

Method

A total of 535 women aged 18-45 years in their 26th week of pregnancy completed questionnaires regarding mindfulness, dyadic satisfaction and cohesion, and depression and anxiety symptoms.

Results

Three profiles were identified: (1) low mindfulness (53.8%), (2) moderate mindfulness (34.3%), and (3) non-judgmentally aware (11.9%). The most adaptive profile was the non-judgmentally aware profile. Compared to the low mindfulness profile, the non-judgmentally aware profile and the moderate mindfulness profile were related to fewer symptoms of depression and anxiety, and these relationships were partly mediated by dyadic satisfaction.

Discussion

These results suggest that analyzing each pregnant woman's mindfulness profile can improve the prevention of and interventions for anxiety and depression.

Longitudinal study of the relationship between number of prior miscarriages or stillbirths and changes in quality of life of pregnant women: the Japan Environment and Children's Study (JECS)

BACKGROUND

Although a history of miscarriage or stillbirth has been reported to negatively affect quality of life (QOL) during the subsequent pregnancy, the association between the number of previous miscarriages or stillbirths and QOL, as well as trends in QOL during pregnancy, has not been clarified. This study sought to determine this association during early and mid- to late pregnancy.

METHODS

Data from 82,013 pregnant women who participated in the Japan Environment and Children's Study (JECS) from January 2011 to March 2014 were analyzed. In early and mid/late pregnancy, participants completed questionnaires and QOL was assessed using the Physical and Mental Component Summary (PCS and MCS, respectively) scores from the 8-item Short-Form Health Survey (SF-8). The pregnant women were divided into four groups according to number of previous miscarriages or stillbirths (0, 1, 2, and ≥ 3), and the PCS and MCS scores in early pregnancy and mid/late pregnancy were compared between group 0 and groups 1, 2, and ≥ 3. Generalized linear mixed models were used for analysis.

RESULTS

PCS score in early pregnancy was lower in group 1 (β =  - 0.29, 95% confidence interval [CI] - 0.42 to - 0.15), group 2 (β =  - 0.45, 95% CI - 0.73 to - 0.18), and group ≥ 3 (β =  - 0.87, 95% CI - 1.39 to - 0.35) than in group 0. Group 1 and group ≥ 3 showed a trend for increased PCS score during pregnancy (β = 0.22, 95% CI 0.07 to 0.37 and β = 0.75, 95% CI 0.18 to 1.33, respectively) compared with group 0.

CONCLUSIONS

PCS score in early pregnancy was lower with a more frequent history of miscarriage or stillbirth. However, in terms of changes in QOL during pregnancy, pregnant women with a history of miscarriage or stillbirth showed greater increases in PCS score during mid/late pregnancy than pregnant women with no history of miscarriage or stillbirth.

Anxiety and depression in pregnant women who have experienced a previous perinatal loss: a case-cohort study from Scandinavia

BACKGROUND

Perinatal loss can have long-lasting adverse effects on a woman's psychosocial health, including during subsequent pregnancies. However, maternal mental health status after perinatal loss during subsequent pregnancy is understudied with very little data available for Scandinavian populations.

AIMS

The primary aim of the study was to explore the association between previous perinatal loss and anxiety/depression symptoms of expectant mothers during the subsequent pregnancy. The secondary aim of this study was to explore possible determinants of maternal mental health during the subsequent pregnancy, independent of previous perinatal loss.

METHOD

This case-cohort study is based on primary data from Scandinavian Successive Small-for-Gestational Age Births Study (SGA Study) in Norway and Sweden. The total case-cohort sample in the current study includes 1458 women. Cases include 401 women who had reported a previous perinatal loss (spontaneous abortion, stillbirth, or neonatal death) and who responded to two mental health assessment instruments, the State-Trait Anxiety Inventory (STAI), and the Centre for Epidemiological Studies Depression (CES-D) scale. Multiple linear regression models were used to assess the association between previous perinatal loss and maternal mental health in subsequent pregnancy.

RESULTS

Scandinavian pregnant women with previous perinatal loss reported higher symptoms for both anxiety and depression during their subsequent pregnancy compared to mothers in the same cohort reported no previous perinatal loss. Multiple linear regression analyses showed a positive association between previous perinatal loss and per unit increase in both total anxiety score (β: 1.22, 95% CI: 0.49-1.95) and total depression score (β: 0.90, 95% CI: 0.06-1.74). We identified several factors associated with maternal mental health during pregnancy independent of perinatal loss, including unintended pregnancy despite 97% of our population being married/cohabitating.

CONCLUSION

Women who have experienced previous perinatal loss face a significantly higher risk of anxiety and depression symptoms in their subsequent pregnancy.

Complicated Grief After the Loss of a Baby: A Systematic Review About Risk and Protective Factors for Bereaved Women

This study sought to identify the factors associated with the development and prevention of complicated grief in women who have lost a baby. This is a systematic review of scientific articles in the main mental health databases: MEDLINE (PubMed), EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS), and APA Databases (PsycINFO). The selection and data extraction processes occurred independently and blindly by two authors, considering the eligibility criteria. The analysis included publications from 2013 to 2021 of observational studies with adult women who had experienced losing a baby (during pregnancy up to 2 years of life) and that employed standardized instruments to evaluate grief. From the 8,200 records found, 23 articles were selected for analysis. As risk factors, we identified the presence of mother’s psychopathology, history of gestational loss, and social pressure for a new pregnancy, while as protective factors, we identified the presence of another child other than the deceased one, the quality of specialized healthcare, and the social support provided by either a partner, community, or spiritual activities. Furthermore, the studies pointed to the event of losing a baby as an opportunity for posttraumatic growth. Although complicated grief is often associated with other mental health conditions, such as anxiety, depression, or posttraumatic stress, it is necessary to differentiate it for a clearer understanding of the complicated grief as a singular condition, to enable access to appropriate care for bereaved mothers and families, as well as to promote public policies which provide support to them.

Centrality of Pregnancy and Prenatal Attachment in Pregnant Nulliparous After Recent Elective or Therapeutic Abortion

Background

There are two types of voluntary interruption of pregnancy: elective and therapeutic abortion. These forms are different for many reasons, and it is reasonable to assume that they can have negative consequences that can last until a subsequent gestation. However, no study has analyzed the psychological experience of gestation after a previous abortion, distinguishing the two forms of voluntary interruption of pregnancy.

Objective

This study aims to explore the level of prenatal attachment and centrality of pregnancy in nulliparous low-risk pregnant women with a recently (<3 years) previous elective or therapeutic abortion.

Methods

A total of 34 nulliparous pregnant women with a history of abortion (23 elective and 11 therapeutic abortion), aged from 27 to 48 years (mean = 37.17), were recruited in the maternity ward of a public hospital of the metropolitan area of Tuscany and Lombardy (Italy) during the third trimester of gestation. The participants filled out a battery of questionnaires aimed at assessing prenatal attachment and centrality of pregnancy.

Results

Analyses of variance showed that women with a history of elective abortion reported a higher centrality of pregnancy than women with a past therapeutic abortion. On the contrary, women with a past therapeutic abortion reported higher prenatal attachment.

Conclusion

Elective and therapeutic abortions are different experiences that impact the way women experience a subsequent pregnancy. Future research should further investigate the psychological experience of gestation after abortion.