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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: a prospective study

Authors: Ida Kathrine Gravensteen, Eva-Marie Jacobsen, Per Morten Sandset, Linda Bjørk Helgadottir, Ingela Rådestad, Leiv Sandvik, Øivind Ekeberg

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

Experiencing a stillbirth can be a potent stressor for psychological distress in the subsequent pregnancy and possibly after the subsequent birth. The impact on women’s relationship with her partner in the subsequent pregnancy and postpartum remains uncertain. The objectives of the study were 1) To investigate the prevalence of anxiety and depression in the pregnancy following stillbirth and assess gestational age at stillbirth and inter-pregnancy interval as individual risk factors. 2) To assess the course of anxiety, depression and satisfaction with partner relationship up to 3 years after the birth of a live-born baby following stillbirth.

Methods

This study is based on data from the Norwegian Mother and Child Cohort Study, a population-based pregnancy cohort. The sample included 901 pregnant women: 174 pregnant after a stillbirth, 362 pregnant after a live birth and 365 previously nulliparous. Anxiety and depression were assessed by short-form subscales of the Hopkins Symptoms Checklist, and relationship satisfaction was assessed by the Relationship Satisfaction Scale. These outcomes were measured in the third trimester of pregnancy and 6, 18 and 36 months postpartum. Logistic regression models were applied to study the impact of previous stillbirth on depression and anxiety in the third trimester of the subsequent pregnancy and to investigate gestational age and inter-pregnancy interval as potential risk factors.

Results

Women pregnant after stillbirth had a higher prevalence of anxiety (22.5%) and depression (19.7%) compared with women with a previous live birth (adjusted odds ratio (aOR) 5.47, 95% confidence interval (CI) 2.90–10.32 and aOR 1.91, 95% CI 1.11–3.27) and previously nulliparous women (aOR 4.97, 95% CI 2.68–9.24 and aOR 1.91, 95% CI 1.08–3.36). Gestational age at stillbirth (> 30 weeks) and inter-pregnancy interval <  12 months were not associated with depression and/or anxiety. Anxiety and depression decreased six to 18 months after the birth of a live-born baby, but increased again 36 months postpartum. Relationship satisfaction did not differ between groups.

Conclusion

Women who have experienced stillbirth face a significantly greater risk of anxiety and depression in the subsequent pregnancy compared with women with a previous live birth and previously nulliparous women.
Literature
1.
Vance JC, Foster WJ, Najman JM, Embelton G, Thearle MJ, Hodgen FM. Early parental responses to sudden infant death, stillbirth or neonatal death. Med J Aust. 1991;155(5):292–7.PubMed
2.
Boyle FM, Vance JC, Najman JM, Thearle MJ. The mental health impact of stillbirth, neonatal death or SIDS: prevalence and patterns of distress among mothers. Sco Sci Med. 1996;43(8):1273–82.CrossRef
3.
4.
5.
6.
Radestad I, Steineck G, Nordin C, Sjogren B. Psychological complications after stillbirth--influence of memories and immediate management: population based study. BMJ. 1996;312(7045):1505–8.CrossRefPubMedPubMedCentral
7.
Cacciatore J, Radestad I, Frederik Froen J. Effects of contact with stillborn babies on maternal anxiety and depression. Birth. 2008;35(4):313–20.CrossRefPubMed
8.
Hughes PM, Turton P, Evans CD. Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study. BMJ. 1999;318(7200):1721–4.CrossRefPubMedPubMedCentral
9.
Forrest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. BMJ. 1982;285(6353):1475–9.CrossRefPubMedPubMedCentral
10.
Bourne S, Lewis E. Pregnancy after stillbirth or neonatal death. Psychological risks and management. Lancet. 1984;2(8393):31–3.CrossRefPubMed
11.
Cote-Arsenault D, Bidlack D, Humm A. Women's emotions and concerns during pregnancy following perinatal loss. MCN Am J Matern Child Nurs. 2001;26(3):128–34.CrossRefPubMed
12.
Turton P, Hughes P, Evans CD, Fainman D. Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth. Br J Psychiatry. 2001;178:556–60.CrossRefPubMed
13.
Cote-Arsenault D. Threat appraisal, coping, and emotions across pregnancy subsequent to perinatal loss. Nurs Res. 2007;56(2):108–16.CrossRefPubMed
14.
Armstrong D, Hutti M. Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachment. J Obstet Gynecol Neonatal Nurs. 1998;27(2):183–9.CrossRefPubMed
15.
Armstrong DS, Hutti MH, Myers J. The influence of prior perinatal loss on parents’ psychological distress after the birth of a subsequent healthy infant. J Obstet Gynecol Neonatal Nurs. 2009;38(6):654–66.CrossRefPubMed
16.
17.
Christoffersen L. Helsevesenet ved dødfødsel. Foreldres opplevelse og bruk av det norske helsevesenet før, under og etter en dødfødsel- et pilotprosjekt [Report in Norwegian]. Oslo School of Management/ Norwegian SIDS and Stillbirth Society 2008;2–60.
18.
Franche RL. Psychologic and obstetric predictors of couples' grief during pregnancy after miscarriage or perinatal death. Obstet Gynecol. 2001;97(4):597–602.PubMed
19.
Janssen HJ, Cuisinier MC, Hoogduin KA, de Graauw KP. Controlled prospective study on the mental health of women following pregnancy loss. Am J Psychiatry. 1996;153(2):226–30.CrossRefPubMed
20.
Theut SK, Pedersen FA, Zaslow MJ, Cain RL, Rabinovich BA, Morihisa JM. Perinatal loss and parental bereavement. Am J Psychiatry. 1989;146(5):635–9.CrossRefPubMed
21.
22.
23.
Radestad I, Sjogren B, Nordin C, Steineck G. Stillbirth and maternal well-being. Acta Obstet Gynecol Scand. 1997;76(9):849–55.CrossRefPubMed
24.
Magnus P, Irgens LM, Haug K, Nystad W, Skjaerven R, Stoltenberg C. Cohort profile: the Norwegian mother and child cohort study (MoBa). Int J Epidemiol. 2006;35(5):1146–50.CrossRefPubMed
25.
Schreuder P, Alsaker E. The Norwegian mother and child cohort study (MoBa) - MoBa recruitment and logistics. Nor Epidemiol. 2014;24(1–2):23–7.
26.
Irgens LM. The medical birth registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obst Gynecol Scand. 2000;79(6):435–9.CrossRef
27.
WHO. ICD-10: international statistical classification of diseases and related health problems – instructional manual. 2nd ed. Geneva: World Health Organization; 2004.
28.
Hesbacher PT, Rickels K, Morris RJ, Newman H, Rosenfeld H. Psychiatric illness in family practice. J Clin Psychiatry. 1980;41(1):6–10.PubMed
29.
Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003;57(2):113–8.CrossRefPubMed
30.
Tambs K, Moum T. How well can a few questionnaire items indicate anxiety and depression? Acta Psychiatr Scand. 1993;87(5):364–7.CrossRefPubMed
31.
Winokur A, Winokur DF, Rickels K, Cox DS. Symptoms of emotional distress in a family planning service: stability over a four-week period. Br J Psychiatry. 1984;144:395–9.CrossRefPubMed
32.
Røysamb EVJ, Tambs K. The relationship satisfaction scale - psychometric properties. Nor Epidemiol. 2014;1-2(24):187–94.
33.
Blum JM. A. Personality and temperament correlates of marital satisfaction. J Pers. 1999;67(1):93–125.CrossRef
34.
Henrick S. A generic measure of relationship satisfaction. J Marriage Fam. 1988;50:93–8.CrossRef
35.
Snyder DK. Marital satisfaction inventory– revised (MSI-R) manual. Los Angeles: Western Psychological Services; 1997.
36.
R. N. Measuring marital quality: a critical look at the dependent variable. J Marriage Fam. 1983(45):141-151.
37.
Dyrdal GM, Roysamb E, Nes RB, Vitterso J. Can a happy relationship predict a happy life? A population-based study of maternal well-being during the life transition of pregnancy, infancy, and toddlerhood. J Happiness Stud. 2011;12:947–62.CrossRefPubMed
38.
39.
Nohr EA, Frydenberg M, Henriksen TB, Olsen J. Does low participation in cohort studies induce bias? Epidemiology. 2006;17(4):413–8.CrossRefPubMed
40.
41.
Bjork MH, Veiby G, Reiter SC, Berle JO, Daltveit AK, Spigset O, et al. Depression and anxiety in women with epilepsy during pregnancy and after delivery: a prospective population-based cohort study on frequency, risk factors, medication, and prognosis. Epilepsia 2015; doi: https://​doi.​org/​10.​1111/​epi.​12884.
42.
Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D, et al. From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the perinatal depression-research & screening unit study. Compr Psychiatry. 2011; https://​doi.​org/​10.​1016/​j.​comppsych.​2010.​08.​003.
43.
Tambs K, Røysamb E. Selection of questions to short-form versions of original psychometric instruments in MoBa. Nor Epidemiol. 2014;24(1–2):195–201.
44.
Moum T. Mode of administration and interviewer effects in self-reported symptoms of anxiety and depression. Soc Indic Res. 1998;45(1):279–318.CrossRef
45.
46.
47.
Metadata
Title
Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: a prospective study
Authors
Ida Kathrine Gravensteen
Eva-Marie Jacobsen
Per Morten Sandset
Linda Bjørk Helgadottir
Ingela Rådestad
Leiv Sandvik
Øivind Ekeberg
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1666-8

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