The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over 13 months
Article first published online: 26 JUL 2007
RCOG 2007 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 9, pages 1138–1145, September 2007
How to Cite
Cumming, G., Klein, S., Bolsover, D., Lee, A., Alexander, D., Maclean, M. and Jurgens, J. (2007), The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over 13 months. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 1138–1145. doi: 10.1111/j.1471-0528.2007.01452.x
- Issue published online: 26 JUL 2007
- Article first published online: 26 JUL 2007
- Accepted 5 June 2007. Published OnlineEarly 26 July 2007.
- hospital anxiety and depression scale;
Objective To identify the trajectories of anxiety and depression in women and in their partners over 13 months after miscarriage.
Design A prospective study with follow up at 6 and 13 months after miscarriage.
Setting Three Scottish Early Pregnancy Assessment Units.
Sample Of the 1443 eligible individuals approached, 686 (48.3%) consented to participate (432 women; 254 men). Complete data were obtained from 273 women and 133 men at baseline, 6, and 13 months.
Methods On completion of the management of the index miscarriage, eligible and consenting women and men underwent an initial assessment comprising a semi-structured interview and a standardised self-report questionnaire. The latter was readministered at the follow-up assessments.
Main outcome measures The hospital anxiety and depression scale (HADS), a reliable and valid measure of general psychopathology for use in nonpsychiatric samples.
Results Compared with depression, anxiety was overall the greater clinical burden. Over the 13-month period, women reported higher levels of anxiety and depression than men. Over time, a significantly greater level of adjustment was reported by women particularly with regards to the resolution of anxiety symptoms. The effect of time on HADS scores in either gender was similar between subgroups of socio-demographic and clinical factors.
Conclusions These findings verify that early pregnancy loss represents a significant emotional burden for women, and to some extent for men, especially with regards to anxiety. For many, the detrimental effects of miscarriage are enduring and display a complex course of resolution. These findings are discussed in terms of their clinical implications for early identification and management.