Emotional distress and prenatal attachment in pregnancy after perinatal loss

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.