Predicting the psychological impact of miscarriage

Abstract

This paper assesses the quantitative evidence concerning the psychological impact of miscarriage on women and considers which factors may predict more negative emotional outcomes. The focus is upon work using concurrent rather than retrospective assessments of emotional symptoms. Studies suggest that between one-fifth and a half of women may show significant symptoms of depression shortly after miscarriage. Findings for anxiety symptoms are less clear primarily because it has been considered as a general dimension rather than related to specific concerns. There are suggestions that while depressive symptoms may diminish more quickly, anxiety may show a more fluctuating pattern. Five groups of potential predictors were identified from the literature: demographic variables, aspects of the pregnancy, reproductive histories, general life factors and aspects of die process of miscarriage hospitalization and follow-up care. Demographic variables in general showed few significant associations with emotional outcome measures. Previous contact with services for emotional problems was, as expected, found to be a positive predictor of emotional distress. The inconsistent results for other potential predictors are discussed in terms of the importance of cognitive variables. Future research needs to utilize multivariate analyses and incorporate recent developments in theories of coping with negative events.