Stepping Back to Gain Perspective: Pregnancy Loss History, Depression, and Parenting Capacity in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B)

Abstract

Previous empirical studies of pregnancy loss have predominantly focused on complex grief response and emergent problems associated with future parenting in self-selected samples of bereaved women. This article presents findings from a retrospective secondary data analysis conducted with a racially and ethnically diverse sample of currently parenting women in the United States (N = 10,688) that examined the relationships among pregnancy loss history, current maternal depressive symptoms, and mother-infant interaction with the enrolled child. Study findings underscore a racial-ethnic disparity in pregnancy loss history for African American women, whereas current maternal depressive symptoms remain fairly constant across racial-ethnic groups. Multiple loss history is associated with a slight elevation in overall symptoms of depression, but there is no relationship between pregnancy loss history and current mother-infant interaction in the study sample. An important limitation in this study is that the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) data does not allow for inferences specific to the type of loss, gestational age of fetus, time since loss, or whether the loss was spontaneous or induced. However, study findings highlight areas of incongruity between clinical and population-based research that deserve further investigation. Ultimately, the findings from this population-based research contribute to a wider perspective regarding maternal response to reproductive loss that can inform future research and targeted bereavement support.

Effect of Previous Miscarriage on Depressive Symptoms During Subsequent Pregnancy and Postpartum in the First Baby Study

“…This is consistent with much of the published research in women with a history of perinatal loss during the second half of the postpartum year. Although Carerra and colleagues (37) found a positive association between a history of stillbirth and increased depressive symptoms at 6 and 12 months postpartum, several other researchers found no difference during this same time period (12, 16, 38). …”

“…These authors found that the number of perinatal losses significantly predicted depressive symptoms at both prenatal and postpartum time points. In contrast, a study using the Early Childhood Longitudinal Study, Birth Cohort based in the United States found no association between a history of one perinatal loss and depression at 9 months postpartum (38). These authors found that having two or more perinatal losses was associated with higher depression when compared to women with no history of loss; however, the difference amounted to 1 point on the depression scale (range 12–48), which may not be clinically significant.…”

Effect of miscarriage history on maternal-infant bonding during the first year postpartum in the First Baby Study: a longitudinal cohort study

“…In one study, mothers of 16-month-old children born subsequent to perinatal loss reported that they were more concerned about the child’s health, and more concerned with the psychological separation between mother and child as the child developed [17]. However, in another study, Price [20] reported that mothers with a history of perinatal loss did not perceive their 9 month old child as more difficult to raise than other children.…”

“…Additionally, according to Price [20], studies in this area of research are often completed using a self-selection of participants based on their willingness to discuss previous perinatal loss experiences. This can create a selection bias where only women with the strongest emotional reaction to perinatal loss are included in the research study.…”

“…Evidence also exists that women with a history of perinatal loss are more concerned with the health of their child [16,17] and report more problems with their child both in early infancy [18] and at school age [19]. However, Price [20] found no difference in the way mothers with a history of perinatal loss interacted with or perceived the behavior of their infants born subsequent to perinatal loss.…”