Determinants of depressive symptoms in the early weeks after miscarriage.
OBJECTIVE
We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss.


METHODS
We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale.


RESULTS
Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort.


CONCLUSIONS
Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy.
Neugebauer
R
R
New York State Psychiatric Institute, Epidemiology of Developmental Brain Disorders Department, NY 10032.
Kline
J
J
O'Connor
P
P
Shrout
P
P
Johnson
J
J
Skodol
A
A
Wicks
J
J
Susser
M
M
D000022:Abortion, Spontaneous / Q000150:complications / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D007348:Insurance, Health; D007406:Interview, Psychological; D017533:Marital Status; D008423:Maternal Age; D009519:New York City / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors