title: Increased risk for postpartum psychiatric disorders among women with past pregnancy loss.
abstract: BACKGROUND
  Scant literature exists on whether prior pregnancy loss (miscarriage, stillbirth, and/or induced abortion) increases the risk of postpartum psychiatric disorders-specifically depression and anxiety-after subsequent births. This study compares: (1) risk factors for depression and/or anxiety disorders in the postpartum year among women with and without prior pregnancy loss; and (2) rates of these disorders in women with one versus multiple pregnancy losses.
  
  
  METHODS
  One-hundred-ninety-two women recruited at first-year pediatric well-child care visits from an urban pediatric clinic provided demographic information, reproductive and health histories. They also completed depression screening tools and a standard semi-structured psychiatric diagnostic interview.
  
  
  RESULTS
  Almost half of the participants (49%) reported a previous pregnancy loss (miscarriage, stillbirth, or induced abortion). More than half of those with a history of pregnancy loss reported more than one loss (52%). Women with prior pregnancy loss were more likely to be diagnosed with major depression (p=0.002) than women without a history of loss. Women with multiple losses were more likely to be diagnosed with major depression (p=0.047) and/or post-traumatic stress disorder (Fisher's exact [FET]=0.028) than women with a history of one pregnancy loss. Loss type was not related to depression, although number of losses was related to the presence of depression and anxiety.
  
  
  CONCLUSIONS
  Low-income urban mothers have high rates of pregnancy loss and often have experienced more than one loss and/or more than one type of loss. Women with a history of pregnancy loss are at increased risk for depression and anxiety, including post-traumatic stress disorder (PTSD), after the birth of a child. Future research is needed to understand the reasons that previous pregnancy loss is associated with subsequent postpartum depression and anxiety among this population of women.
authors.affiliation: Veterans' Administration Puget Sound Health Care System, Seattle, WA 98108, USA. Stephanie.giannandrea2@va.gov
authors.forename: Stephanie A M
authors.initials: SA
authors.lastname: Giannandrea
authors.forename: Catherine
authors.initials: C
authors.lastname: Cerulli
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Anson
authors.forename: Linda H
authors.initials: LH
authors.lastname: Chaudron
mesh_terms: D000028:Abortion, Induced / Q000523:psychology* / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult