Emotional Distress and Prenatal Attachment in Pregnancy After Perinatal Loss

Authors

  • Deborah Smith Armstrong

    Corresponding author
    1. Deborah Smith Armstrong, RN, PhD, Iota Zeta, Assistant Professor, University of Louisville School of Nursing, Louisville, KY
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  • This study was funded by grants from: Sigma Theta Tau International and American Nurses Foundation, and a Woodrow Wilson/Johnson and Johnson Dissertation Fellowship. An additional small research grant was awarded from the Iota Zeta chapter of Sigma Theta Tau International at the University of Louisville. The author gratefully acknowledges Dr. M.K. Raynes for her consultation on the data analysis.

Dr. Armstrong, K-Building, School of Nursing, University of Louisville, Louisville, KY 40292. E-mail: dsarms01@gwise.louisville.edu

Abstract

Purpose: To evaluate the association of previous perinatal loss with parents' levels of depressive symptoms, pregnancy-specific anxiety, and prenatal attachment in a subsequent pregnancy, and to determine whether higher levels of depressive symptoms and pregnancy-specific anxiety were associated with prenatal attachment.

Design: A three-group comparative design was used to collect cross-sectional survey data. The sample consisted of 103 couples who were in the second trimester of pregnancy: 40 couples who had a perinatal loss in a previous pregnancy, 33 couples were pregnant for the first time, and 30 couples had a history of prior successful pregnancies.

Methods: Structured questionnaires via in-person or telephone interviews were used to measure depressive symptoms, pregnancy-specific anxiety, and prenatal attachment.

Findings: Couples with a history of perinatal loss had higher levels of depressive symptoms and pregnancy-specific anxiety than did couples with past successful pregnancies and no losses; mothers had higher levels of symptoms than did fathers in all groups. Couples with and without a history of perinatal loss did not differ in their level of prenatal attachment in the current pregnancy.

Conclusions: These findings do not support the theory that depressive symptoms and pregnancy-specific anxiety affect subsequent parent-infant attachment in a pregnancy after perinatal loss. However, they do provide insight into the continuing influence of parents' previous loss experience on their depressive symptoms and pregnancy-specific anxiety in subsequent pregnancies. Families should be assessed to examine the potential long-term influence of emotional distress as a result of prior perinatal loss.

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