The impact of early pregnancy loss on adolescents.
OBJECTIVE
The purpose of this study was to determine the impact of early pregnancy loss on adolescents' self-esteem, symptoms of depression, family relationships, grief responses, and perception of life changes.


METHODS
A cross-sectional, comparison design was used to examine responses of 164 never-married, sexually active, low socio-economic females ages 13 to 19 years. Adolescents were placed in four groups based on pregnancy status: (1) Never Pregnant, (2) Pregnant, (3) Early Pregnancy Loss, and (4) Early Pregnancy Loss and Subsequent Pregnancy.


METHODS
Reliable and valid instruments measuring self-esteem, symptoms of depression, family relationships, grief responses, and perception of life changes were used. ANOVA, chi square, t tests, and posthoc tests were used in data analyses.


RESULTS
The Early Pregnancy Loss group (group 3) had significantly higher scores than all other groups on overall grief responses, grief subscales, and depressive symptoms. Groups 3 and 4 had higher physical, emotional, social, and cognitive grief scores versus Groups 1 and 2.


CONCLUSIONS
Adolescents who experience early pregnancy loss may have significant physical, emotional, social, and cognitive grief responses and may be at risk for depressive symptoms. Nurses should assess adolescents' responses to early pregnancy loss and provide sensitive nursing care. Discharge planning should include verbal and written information on the bereavement process and grief responses, anticipatory guidance, when and how to access health care, and referral as appropriate.
Wheeler
S R
SR
University of Illinois at Chicago, College of Nursing, Urbana Regional Campus, 408 South Goodwin, Urbana, IL 61832, USA. wheeler1@uiuc.edu
Austin
J K
JK
D000028:Abortion, Induced / Q000451:nursing / Q000523:psychology*; D000022:Abortion, Spontaneous / Q000451:nursing / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D003863:Depression; D005260:Female; D006117:Grief; D006801:Humans; D016389:Maternal-Child Nursing; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires