title: The influence of prior perinatal loss on parents' psychological distress after the birth of a subsequent healthy infant.
abstract: OBJECTIVE
  To evaluate the long-term influence of a previous perinatal loss on parents' psychological distress during a subsequent childbearing experience.
  
  
  METHODS
  A cohort design was used to examine 36 couples with a history of prior perinatal loss. Data were collected during the third trimester of pregnancy, 3 months postpartum, and again 8 months after birth.
  
  
  METHODS
  Outcome measures included posttraumatic stress (The Impact of Event Scale), depressive symptoms (Center for Epidemiologic Studies-Depression Scale), anxiety (Spielberger State-Trait Anxiety Inventory), and parental concerns and attitudes (Maternal/Paternal Attitudes Questionnaire).
  
  
  RESULTS
  Levels of depressive symptoms (p<.001), anxiety (p<.001), and posttraumatic stress (p=.046) significantly decreased over time in this population. However, levels of posttraumatic stress remained in the moderate range even at 8 months after birth. Depression was significantly correlated with posttraumatic stress at each time point. In addition, depression was significantly related to posttraumatic stress, anxiety, and concerns parents had about their infant's well-being at T3.
  
  
  CONCLUSIONS
  While levels of anxiety and depressive symptoms decreased for parents who have experienced a previous perinatal loss, posttraumatic stress levels remained moderately high. It is unclear how this compares to parents without losses. These may be the unique symptoms and concerns these parents have about their new infant. Parents with a history of prior loss should have assessments carefully tailored to their experiences to anticipate continued psychological distress.
authors.affiliation: School of Nursing, University of Louisville, Louisville, KY.. Electronic address: dsarms01@louisville.edu.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Armstrong
authors.affiliation: School of Nursing, University of Louisville, Louisville, KY.
authors.forename: Marianne H
authors.initials: MH
authors.lastname: Hutti
authors.affiliation: Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY.
authors.forename: John
authors.initials: J
authors.lastname: Myers
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005220:Fathers / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D054238:Perinatal Mortality; D011247:Pregnancy / Q000523:psychology*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D013315:Stress, Psychological