The purpose of this cross-sectional, three-group comparative study was to evaluate the association of previous perinatal loss with levels of depressive symptoms, prenatal anxiety, and prenatal attachment in a subsequent pregnancy. The specific aims were to: (1) determine whether expectant parents differ in levels of depressive symptoms, pregnancy-specific anxiety, and prenatal attachment by gender and group; (2) evaluate the impact of prior perinatal loss on depressive symptoms, pregnancy-specific anxiety, and prenatal attachment in a subsequent pregnancy by gender of the parent; and (3) compare the influence of current depressive symptoms and pregnancy-specific anxiety on prenatal attachment of parents by gender and group.
Three groups of parents (N = 103 couples) were recruited: 33 couples in their first pregnancy, 30 with prior successful pregnancies, and 40 couples with prior perinatal losses. Parents in the loss group were recruited if the current pregnancy was preceded by their prior loss(es). Depressive symptoms, pregnancy-specific anxiety, and prenatal attachment were measured in all groups. The impact of the perinatal loss was measured for parents in the loss group. Data were collected via structured in-person or telephone interviews.
Parents with a history of prior perinatal loss had higher depressive symptoms and pregnancyspecific anxiety than parents from either of the comparison groups; mothers had higher scores than fathers on the three variables across all groups. Eighty-nine percent of the parents with prior losses scored in the high impact range (score ≥ 19) on the Impact of Event Scale. The impact of the perinatal loss was significantly correlated with both depressive symptoms (r = .53, p < .0001) and prenatal anxiety (r = .47, p < .0001). Parents with and without a perinatal loss did not differ on their level of prenatal attachment during the current pregnancy.
These findings do not support the influence of depressive symptoms and pregnancy-specific anxiety on the developing relationship between parents and their unborn infant in a pregnancy after loss. However, they do provide insight into the continuing influence of parents' previous loss experience on their emotions in future pregnancies. Methods to reduce this emotional distress should be tested in future research. Families should be followed after the birth of a subsequent child to examine the long-term influence of prior perinatal loss on this new parent-child relationship.
