Marriage and cohabitation outcomes after pregnancy loss.
OBJECTIVE
The goal was to evaluate marriage and cohabitation outcomes for couples who experienced a live birth or fetal death at any gestational age.


METHODS
For married and cohabitating women who experienced live births, miscarriages, or stillbirths, we conducted a survival analysis (median follow-up period: 7.8 years), by using data from the National Survey of Family Growth, to examine the association between birth outcomes and subsequent relationship survival. The Cox proportional-hazards models controlled for multiple independent risk factors known to affect relationship outcomes. The main outcome measure was the proportion of intact marriages or cohabitations over time.


RESULTS
Of 7770 eligible pregnancies, 82% ended in live births, 16% in miscarriages, and 2% in stillbirths. With controlling for known risk factors, women who experienced miscarriages (hazard ratio: 1.22 [95% confidence interval: 1.08-1.38]; P = .001) or stillbirths (hazard ratio: 1.40 [95% confidence interval: 1.10-1.79]; P = .007) had a significantly greater hazard of their relationship ending, compared with women whose pregnancies ended in live births.


CONCLUSIONS
This is the first national study to establish that parental relationships have a higher risk of dissolving after miscarriage or stillbirth, compared with live birth. Given the frequency of pregnancy loss, these findings might have significant societal implications if causally related.
Gold
Katherine J
KJ
University of Michigan, Department of Family Medicine, Ann Arbor, MI 48104-1213, USA. ktgold@umich.edu
Sen
Ananda
A
Hayward
Rodney A
RA
D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D016016:Proportional Hazards Models; D012307:Risk Factors; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data*; D050497:Stillbirth / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D055815:Young Adult