title: Depression as a potential causal factor in subsequent miscarriage in recurrent spontaneous aborters.
abstract: BACKGROUND
  Unexplained miscarriage is speculated to be due to a Th1/Th2 cytokine imbalance at the feto-maternal interface and immunological functions are known to be under the influence of various psychological factors. Indeed, the psycho-neuro-immuno-endocrine network has been proposed to contribute to miscarriage. To assess whether psychological disorders might induce spontaneous abortion we carried out a prospective study to determine if any psychological parameter influenced risk in those patients with a history of recurrent miscarriages.
  
  
  METHODS
  A prospective study was carried out on 61 patients with a history of two consecutive first-trimester miscarriages. A battery of self-report questionnaires including Symptom Checklist-90 Revised and the NEO Five Factor Index and semi-structured interviews were conducted before a subsequent pregnancy. We investigated whether or not these parameters predicted subsequent miscarriages.
  
  
  RESULTS
  Ten (22.2%) of the 45 patients who conceived miscarried again. Baseline depressive symptoms influenced subsequent miscarriage (P = 0.004). This statistically significant effect remained when we corrected with Bonfferoni adjustment (P = 0.036).
  
  
  CONCLUSIONS
  A high depression scale is associated with a high miscarriage rate in those patients suffering recurrent miscarriage.
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology / Q000523:psychology*; D000328:Adult; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires