O-156 Pregnancy loss has significant mental health consequences, a prospective cohort study of 2,085 women and 1,212 partners

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Abstract Study question What is the prevalence of stress, depression and anxiety among couples experiencing pregnancy loss and is this affected by reproductive history? Summary answer Depression, stress, and anxiety are common after pregnancy loss, especially among women. Couples with prior losses and failed primary treatment are especially vulnerable. What is known already Studies of mental health consequences of pregnancy loss present a complex and inconsistent picture and reported rates of depression, stress, and anxiety varies significantly in prior research. Several factors likely contribute to this variability: many studies are relatively old and may not reflect current experiences and cultural norms and samples sizes are generally small which may impact reliability and generalizability of the results. Furthermore, research often focuses solely on the mother, overlooking potential mental health impacts on partners. Study design, size, duration Prospective cohort study with 2,085 women and 1,212 partners included between November 2020 and December 2024. Participants/materials, setting, methods Women with miscarriage before 22 weeks’ gestation and their partners. Two to eight weeks after the loss, participants completed psychometric scales including Major Depression Index (MDI), Perceived Stress Scale (PSS) and Generalized Anxiety Disorder-7 (GAD-7). Univariate comparison of the psychometric scales to eight covariates were performed on women and partners separately and adjusted for age where relevant. Odds-ratios were found using a proportional-odds model, and confidence intervals and p-values were estimated using a Wald’s test. Main results and the role of chance For women, median (IQR) on the MDI was 15 (9; 25), 253 (12.2%) had moderate/severe depression. Median on the PSS was 18 (13; 24), 1030 women (49.4%) were stressed (PSS>18). Median on the GAD-7 was 6 (2; 9), 499 women (24.1%) had moderate/severe anxiety. Having children was correlated with lower scores, OR (95% CI): MDI: 0.67 (0.57; 0.78), p < 0.001; PSS: 0.75 (0.64; 0.87), p < 0.001; GAD-7: 0.78 (0.67; 0.91), p = 0.004. Prior losses correlated with higher scores: MDI 1.17 (1.10;1.23), p < 0.001; PSS 1.15 (1.09; 1.22), p < 0.001; GAD-7: 1.15 (1.09; 1.22), p < 0.001, as did repeated treatment due to retained tissue: MDI: 1.41 (1.13; 1.76), p = 0.005 and PSS: 1.31 (1.05; 1.63), p = 0.03. Among partners, median score (IQR) on the MDI was 8 (4, 15), 46 (3.8%) had moderate/severe depression. PSS median: 14 (9, 18), 286 (23.6%) were stressed; GAD-7: 3 (0, 6) and 99 (8.3%) had moderate/severe anxiety. Prior losses correlated with higher scores on the MDI: 1.14 (1.06; 1.23), p = 0.007, PSS: 1.12 (1.05; 1.20), P = 0.01, and GAD7: 1.10 (1.03; 1.19), p = 0.03. Limitations, reasons for caution Studies based on self-reported symptoms have inherent limitations in that participants may over- or under-report symptoms due to recall bias and differences in interpretations of symptom severity. However, the rating scales used are validated and widely used internationally. Wider implications of the findings The results of this study imply that pregnancy loss care could be improved by including mental health assessments for both women and their partners. Couples with prior losses and women where primary treatment is insufficient are especially at risk and tailored care should be provided. Trial registration number No

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