Early pregnancy loss (EPL) is common, affecting up to 25% of pregnancies. Studies looking at the emotional consequences of miscarriage have shown that most women do well; however, some women experience clinically significant symptoms of depression and anxiety.
In a previous study, Farren and colleagues prospectively examined the type and severity of emotional symptoms women experienced after an early pregnancy loss (n = 128), as compared to women with viable ongoing pregnancies (n = 58). At one month, 28% of the women had symptoms suggestive of PTSD. At three months, even more women (38%) experienced PTSD symptoms.
In another study from the same group, Farren and colleagues prospectively followed women and their partners recruited from early pregnancy units of three hospitals in central London. At one, three and nine months after experiencing an early pregnancy loss, participants received an email link to surveys assessing symptoms using the Hospital Anxiety and Depression Scale (HADS) and the Post-traumatic Diagnostic Scale (PDS). The proportion of participants meeting screening criteria for moderate/severe anxiety or depression and post-traumatic stress (PTS) was assessed.
A total of 386 couples were approached after experiencing a pregnancy loss,192 couples were enrolled into the study. All partners were male. At 1, 3 and 9 months, response rates were 57%, 45% and 38% for partners, and 76%, 68% and 57% for women, respectively.
Post-traumatic stress symptoms were reported in 7% of the partners at month 1, 8% at month 3 and 4% at month 9, compared to 34%, 26% and 21%, respectively, in women. Partners experienced lower rates of moderate/severe anxiety (6% vs 30% at month 1, 9% vs 25% at month 3, 6% vs 22% at month 9) and depression (2% vs 10% at month 1, 5% vs 8% at month 3, 1% vs 7% at month 9). Morbidity for each outcome decreased over time in women and their partners, indicating no evidence of a different trajectory of symptoms in women and their partners.
Typically women who have an early pregnancy loss do not receive any specific medical or psychological follow up; even less attention is devoted to the mental wellbeing of their partners after pregnancy loss. While this study documents lower rates of post-traumatic stress, anxiety and depressive symptoms in partners compared to the women themselves, some partners may benefit from support and interventions to reduce symptoms of depression and anxiety.
Ruta Nonacs, MD PhD
Farren J, Jalmbrant M, Falconieri N, Mitchell-Jones N, Bobdiwala S, Al-Memar M, Tapp S, Van Calster B, Wynants L, Timmerman D, Bourne T. Differences in post-traumatic stress, anxiety and depression following miscarriage and ectopic pregnancy between women and their partners: a multicenter prospective cohort study. Ultrasound Obstet Gynecol. 2020 Oct 8.
Farren J, Jalmbrant M, Ameye L, Joash K, Mitchell-Jones N, Tapp S, Timmerman D, Bourne T. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open. 2016 Nov 2;6(11):10. Free Article
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