Impact of prior perinatal loss on subsequent pregnancies

Objective: To evaluate the influence of previous perinatal loss on depressive symptoms, pregnancy-specific anxiety, and prenatal attachment for parents during subsequent pregnancies. Design: Cross-sectional, survey design. Participants: Forty expectant couples who experienced a prior perinatal loss. Measures: influence of loss (Impact of Event Scale [IES]), depressive symptoms (Center for Epidemiologic Studies-Depression Scale [CES-D]), pregnancy-specific anxiety (Pregnancy Outcome Questionnaire [POQ]), and prenatal attachment (Prenatal Attachment Inventory [PAI]). Results: Mothers reported higher levels of depressive symptoms, pregnancy-specific anxiety and prenatal attachment than fathers did. Forty-five percent of mothers and 23% of fathers had CES-D scores greater than or equal to 16 indicating high risk for depression. Eighty-eight percent of mothers and 90% of fathers reported elevated stress related to the prior loss (IES scores greater than or equal to 19). The impact of the previous perinatal loss was moderately correlated with depressive symptoms as well as pregnancy-specific anxiety. There was no relationship between the psychological distress in pregnancy after perinatal loss and prenatal attachment. Conclusions: The extent to which the impact of the prior loss increased parents' stress in the current pregnancy influenced their psychological distress. These findings should heighten awareness of the mixture of hope and fear expectant parents experience during pregnancies subsequent to perinatal loss.