Are Past Adverse Pregnancy Outcomes Associated with Maternal Anxiety and Depressive Symptoms in a Sample of Currently Pregnant Women?

Amanuel Alemu Abajobir; Rosa Alati; Steve Kisely; Jake Moses Najman

doi:10.4314/ejhs.v27i4.6

Are Past Adverse Pregnancy Outcomes Associated with Maternal Anxiety and Depressive Symptoms in a Sample of Currently Pregnant Women?

Ethiop J Health Sci. 2017 Jul;27(4):351-362. doi: 10.4314/ejhs.v27i4.6.

Authors

Amanuel Alemu Abajobir¹, Rosa Alati^{1

2}, Steve Kisely^{3

4}, Jake Moses Najman^{1

5

6}

Affiliations

¹ School of Public Health, The University of Queensland, Australia.
² Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
³ School of Medicine, University of Queensland, Australia.
⁴ Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada.
⁵ School of Social Sciences, The University of Queensland, Australia.
⁶ Queensland Alcohol and Drug Research and Education Centre, the University of Queensland, Australia.

Abstract

Background: There has been a great deal of concern about the mental health of women whose pregnancies involve miscarriage, termination of a pregnancy (ToP), child death or where a child has been given up for adoption. Despite this concern there has been remarkably little population-based research which has addressed the long-term consequences of pregnancy loss and child death. This study investigated the maternal mental health consequences of women whose pregnancies involve miscarriage, ToP, child death or where a child has been given up for adoption at two different time points, adjusting for socio-demographic characteristics and baseline mental health.

Methods: The Mater-University of Queensland Study of Pregnancy is a prospective pre-birth cohort study. Women were recruited early in pregnancy over the period 1981 to 1983 at their first antenatal clinic visit (FCV). Women were interviewed again at the 14-year follow-up. Data from 4403 mothers were analysed using maternal reports of a prior history of giving a child up for adoption, miscarriage, ToP, and neonatal, infant and/or child deaths. Symptoms of maternal anxiety and depression were measured at FCV and the 14-year follow-up using the Delusions-Symptoms-States Inventory. We carried out logistic regression analysis using Stata 13. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to display the findings.

Results: A prior miscarriage was associated with anxiety (adjusted OR (AOR) = 1.30; 95% CI: 1.10-1.66) and depressive (AOR = 1.70; 95% CI: 1.21-2.39) symptoms at the 14-year follow-up. Having had a neonatal, infant and/or child deaths was associated with symptoms of depression at 14-year follow-up (AOR = 2.12; 95% CI: 1.06-4.25).

Conclusion: The period after a child loss which involves a new pregnancy may be associated with relatively good mental health despite the fact that some mothers have experienced previous adverse pregnancy outcomes.

Keywords: Women; adoption; anxiety; death of neonatal; depression; infant and/or child; miscarriage; termination of pregnancy.

MeSH terms

Abortion, Induced / psychology
Abortion, Spontaneous / psychology
Adolescent
Adoption / psychology
Adult
Anxiety / etiology*
Depression / etiology*
Female
Humans
Infant
Infant Death
Logistic Models
Odds Ratio
Perinatal Death
Pregnancy
Pregnancy Complications / psychology*
Pregnancy Outcome / psychology*
Pregnant Women / psychology*
Prenatal Care
Prospective Studies
Queensland
Risk Factors
Young Adult