title: Emotional distress and prenatal attachment in pregnancy after perinatal loss.
abstract: OBJECTIVE
  To evaluate the association of previous perinatal loss with parents' levels of depressive symptoms, pregnancy-specific anxiety, and prenatal attachment in a subsequent pregnancy, and to determine whether higher levels of depressive symptoms and pregnancy-specific anxiety were associated with prenatal attachment.
  
  
  METHODS
  A three-group comparative design was used to collect cross-sectional survey data. The sample consisted of 103 couples who were in the second trimester of pregnancy: 40 couples who had a perinatal loss in a previous pregnancy, 33 couples were pregnant for the first time, and 30 couples had a history of prior successful pregnancies.
  
  
  METHODS
  Structured questionnaires via in-person or telephone interviews were used to measure depressive symptoms, pregnancy-specific anxiety, and prenatal attachment.
  
  
  RESULTS
  Couples with a history of perinatal loss had higher levels of depressive symptoms and pregnancy-specific anxiety than did couples with past successful pregnancies and no losses; mothers had higher levels of symptoms than did fathers in all groups, Couples with and without a history of perinatal loss did not differ in their level of prenatal attachment in the current pregnancy.
  
  
  CONCLUSIONS
  These findings do not support the theory that depressive symptoms and pregnancy-specific anxiety affect subsequent parent-infant attachment in a pregnancy after perinatal loss. However, they do provide insight into the continuing influence of parents' previous loss experience on their depressive symptoms and pregnancy-specific anxiety in subsequent pregnancies. Families should be assessed to examine the potential long-term influence of emotional distress as a result of prior perinatal loss.
authors.affiliation: University of Louisville School of Nursing, Louisville, KY, USA. dsarms01@gwise.louisville.edu
authors.forename: Deborah Smith
authors.initials: DS
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000451:nursing; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000451:nursing; D005260:Female; D005313:Fetal Death; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D009773:Obstetric Nursing; D010287:Parent-Child Relations; D011247:Pregnancy / Q000523:psychology*; D011795:Surveys and Questionnaires