Recurrent pregnancy loss: couples’ perspectives on their need for treatment, support and follow up

Koert, Emily; Malling, Gritt Marie Hviid; Sylvest, Randi; Krog, Maria Christine; Kolte, Astrid Marie; Schmidt, Lone; Nielsen, Henriette Svarre

doi:10.1093/humrep/dey362

Cited by 68 publications

(81 citation statements)

References 18 publications

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“…Depression in women with RPL was more than ve times higher than in healthy women. Koert E et al [7] reported that previous RPL might be a predictor of prenatal depression and postpartum depression. In conclusion, pregnancy loss disease interacts with negative psychological situations.…”

Section: Discussionmentioning

confidence: 99%

“…Almost a third and a fth of outpatients with RPL history are diagnosed as having depression and anxiety, respectively [3][4][5][6]. The maternal depression and anxiety problems after miscarriage possibly result in failure of the next pregnancy and adverse birth outcomes; however, the relevant literature is lacking in evidence to this effect [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Wang

Meng

Pei

et al. 2020

Preprint

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Background: To evaluate the depression–anxiety interaction with the development of recurrent pregnancy loss (RPL). Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. The logistic regression and the addition and multiplication interaction effects between anxiety and depression to RPL were analysed.Results: The prevalence of anxiety (28.7% vs. 19.5%) and depression symptoms (48.6% vs. 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjustment for possible confounding variables, compared with the non-RPL participants without depression and anxiety symptoms, the odds ratio (OR) value, reflecting the multiplicative interaction, was 2.788 (95%CI: 1.511–5.144, P < 0.001) for cases with both anxiety and depression symptoms. Moreover, among these, the OR for cases with mild anxiety and severe depression was 5.369 (95%CI: 1.074–26.832, P < 0.001), and the OR for cases with severe anxiety and mild depression was 5.339 (95%CI: 1.033–27.590, P < 0.001). The relative excess risk of interaction value (RERI), reflecting the additive interaction between anxiety and depression to RPL was also 1.148 (95%CI: 0.316–4.212).Conclusions: Either depression or anxiety alone could increase risk of subsequent RPL. There also was a synergistic effect of anxiety and depression after the first miscarriage that increased the development of subsequent RPL disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Wang

Meng

Pei

et al. 2020

Preprint

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“…Depression in women with RPL was more than ve times higher than that in healthy women. Koert E et al [24] reported that previous RPL might be a predictor of prenatal and postpartum depression. In conclusion, our conclusion was consistent with that reported in previous literature.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Anxiety and depression are risk factors for recurrent pregnancy loss: A nested case-control study

Wang

Meng

Pei

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To evaluate the interaction of depression and anxiety with the development of recurrent pregnancy loss (RPL).Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, self-rating anxiety scale and self-rating depression scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. All patients diagosed RPL were recruited as cases whilst a randomly selected group of women with only one miscarriage in the past were recruited as controls. The logistic regression and the interaction effects between anxiety and depression and RPL were analysed.Results: The prevalence of anxiety (n=325, 28.7% vs. n=278, 19.5%) and depression symptoms (n=550, 48.6% vs. n=589, 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjusting for possible confounding variables, the odds ratio (OR) value, reflecting the multiplicative interaction, was 1.91 (95% CI: 1.50–2.44, P<0.001) for cases with both anxiety and depression symptoms compared with the non-RPL group. The relative excess risk of interaction value, reflecting the additive interaction between anxiety and depression to RPL was 1.15 (95% CI: 0.32–4.21). Moreover, the adjusted OR for RPL cases with mild anxiety and severe depression was 2.77 (95% CI:1.07-44.14, P<0.001) , for RPL cases with severe anxiety and mild depression was 4.23 (95% CI: 1.01–22.21, P<0.001), for RPL cases with severe anxiety and moderate depression was 4.34 (95% CI: 1.03–21.28, P<0.001) and for RPL cases with severe anxiety and severe depression was 5.95 (95% CI: 1.09–45.09, P<0.05).Conclusions: Either depression or anxiety alone could increase the risk of subsequent RPL. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent RPL disease.

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“…Individuals carrying a balanced structural chromosomal abnormality are at risk for infertility and may produce gametes with an unbalanced karyotype. An unbalanced conceptus may lead to failure to implant; early or late miscarriage; or more seldom an ongoing pregnancy of a foetus with an unbalanced karyotype resulting in physical or mental disabilities in the child [1,2]. The risk for an unbalanced karyotype in offspring depends on the chromosomes involved and the type of chromosomal abnormality [3].…”

Section: Introductionmentioning

confidence: 99%

Motives and considerations regarding PGT in couples carrying a structural chromosomal abnormality: a qualitative exploration

Krom

Severijns

Vlieg

et al. 2020

J Assist Reprod Genet

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Purpose This study aims to describe the motives and considerations of couples carrying a structural chromosomal abnormality deciding on preimplantation genetic testing (PGT). Methods A qualitative exploratory study was conducted using semi-structured dyadic interviews with 13 couples (N = 26) carrying a structural chromosomal abnormality. All couples had an informative consultation in our PGT centre in the Netherlands. Results Almost all couples considered PGT or natural conception combined with prenatal diagnosis (PND) as the only two reproductive options. Among several considerations mentioned, the majority indicated that the wish to increase the chance of a successful pregnancy was the most important motive to opt for PGT. All couples who opted for PGT had first tried to conceive spontaneously and entered the PGT programme because of their adverse experiences during these attempts (infertility, recurrent miscarriage, termination of pregnancy, birth of an affected child). Couples that refrained from PGT were of advanced maternal age and expressed the long trajectory of PGT as the main reason to refrain. If conceiving spontaneously would not lead to an ongoing pregnancy, these couples also indicated that they would use PGT. Conclusion This study shows that couples carrying a structural chromosomal abnormality consider PGT and spontaneous conception with PND as relevant reproductive options. They are looking for the option that is in their opinion the fastest way to establish a successful pregnancy. Information on the perceived pros and cons of PGT or spontaneous conception in these couples can help to optimize counselling and psychological support during the decision-making process.

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Recurrent pregnancy loss: couples’ perspectives on their need for treatment, support and follow up

Cited by 68 publications

References 18 publications

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Anxiety and depression are risk factors for recurrent pregnancy loss: A nested case-control study

Motives and considerations regarding PGT in couples carrying a structural chromosomal abnormality: a qualitative exploration

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