title: Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss.
abstract: OBJECTIVE
  Is the prevalence of psychological stress and moderate/severe depression higher for women with recurrent pregnancy loss (RPL) than pregnancy planners trying to conceive naturally?
  
  
  CONCLUSIONS
  Both psychological stress and major depression are significantly more common among women with RPL than in those trying to conceive naturally.
  
  
  BACKGROUND
  RPL has a significant emotional impact on couples, especially the woman. Previous studies have shown inconclusive results.
  
  
  METHODS
  In this cross-sectional study, we compared the prevalence of stress and depression among 301 women with RPL and 1813 women attempting to conceive naturally. We defined RPL as three or more pregnancy losses before 12 weeks' gestation. RPL patients were enrolled from 2010 to 2013 and the comparison group from 2011 to 2014.
  
  
  METHODS
  RPL patients completed an online questionnaire before their first consultation at the Danish RPL Unit. In addition, we included data from a comparison group of 1813 women who participated in the Soon Parents Study (www.SnartForældre.dk). The Major Depression Index (MDI) was used to assess symptoms of depression, and Cohen's Perceived Stress Scale (PSS) was used to measure stress. Relevant demographic data were also retrieved.
  
  
  RESULTS
  Of the RPL patients, 26 (8.6%) had a score on the MDI corresponding to moderate/severe depression, as did 40 (2.2%) of the women in Soon Parents Study (adjusted odds ratio (OR) 5.53 (95% confidence interval (CI): 2.09; 14.61)). A high stress level, defined as ≥19 on the PSS scale, was reported by 124 (41.2%) of the patients and 420 (23.2%) in the comparison group (adjusted OR 1.59 (95% CI 1.03; 2.44)).
  
  
  CONCLUSIONS
  We used online questionnaires, and have no interview data. We were unaware if any of the women in the comparison group suffer from RPL.
  
  
  CONCLUSIONS
  This study should entail a heightened awareness of mental distress among care providers for women with RPL.
  
  
  BACKGROUND
  No specific funding was sought for this study. The Soon Parents Study is funded by National Institute of Child Health and Human Development (R01 HD060680-01A4). No authors have competing interests to declare.
  
  
  BACKGROUND
  N/A.
authors: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark astrid.marie.kolte@regionh.dk.
authors: A M
authors: AM
authors: Kolte
authors: Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark.
authors: L R
authors: LR
authors: Olsen
authors: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors: E M
authors: EM
authors: Mikkelsen
authors: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark Department of Obstetrics and Gynaecology, Aalborg Hospital, Aalborg, Denmark.
authors: O B
authors: OB
authors: Christiansen
authors: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark.
authors: H S
authors: HS
authors: Nielsen
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology* / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cross-sectional study; depression; recurrent pregnancy loss; stress