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Cited by 33Grief, Bereavement, and Mental HealthPrenatal Screening and DiagnosticsMaternal Mental Health During Pregnancy and Postpartum

Pregnancy continuation and organizational religious activity following prenatal diagnosis of a lethal fetal defect are associated with improved psychological outcome: Psychological outcome following prenatal diagnosis of a lethal fetal defect

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Cope, Heidi, Garrett, Melanie E., Gregory, Simon, Ashley-Koch, Allison·2015·Prenatal Diagnosis
DOI 10.1002/pd.4603PMC PMC4968036
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Abstract

OBJECTIVE: The aim of the article is to examine the psychological impact, specifically symptoms of grief, post-traumatic stress and depression, in women and men who either terminated or continued a pregnancy following prenatal diagnosis of a lethal fetal defect. METHOD: This project investigated a diagnostically homogeneous group composed of 158 women and 109 men who lost a pregnancy to anencephaly, a lethal neural tube defect. Participants completed the Perinatal Grief Scale, Impact of Event Scale - Revised and Beck Depression Inventory-II, which measure symptoms of grief, post-traumatic stress and depression, respectively. Demographics, religiosity and pregnancy choices were also collected. Gender-specific analysis of variance was performed for instrument total scores and subscales. RESULTS: Women who terminated reported significantly more despair (p = 0.02), avoidance (p = 0.008) and depression (p = 0.04) than women who continued the pregnancy. Organizational religious activity was associated with a reduction in grief (Perinatal Grief Scale subscales) in both women (p = 0.02, p = 0.04 and p = 0.03) and men (p = 0.047). CONCLUSION: There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis. Following a lethal fetal diagnosis, the risks and benefits, including psychological effects, of termination and continuation of pregnancy should be discussed in detail with an effort to be as nondirective as possible.

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  • Quantitative studies comparing heterosexual couples' experiences following pregnancy loss and neonatal death suggest that men typically experience less intense and enduring levels of grief than women.

    “For example, quantitative studies comparing heterosexual couples’ experiences following pregnancy loss and neonatal death suggest that men typically experience less intense and enduring levels of grief than women [18–23].”

    From Factors contributing to men’s grief following pregnancy loss and neonatal death: further development of an emerging model in an Australian sample (2021) · cites this paper as [20]

    The Introduction (page unavailable) says that a few quantitative studies of pregnancy loss due to fetal anomalies suggest men experience grief to a lesser degree and perhaps for a shorter period. The Results and Discussion (page unavailable) also report greater distress among women in this study of losses involving anencephaly. The source supports the suggested gender pattern, but its evidence is limited to lethal fetal defects rather than pregnancy loss and neonatal death generally. (LLM, conf=0.83)

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  • With the exception of one study which employed author-developed measures of grief and support service satisfaction, the remaining quantitative studies employed standardised and validated measures for both predictors and grief.

    “With the exception of one study which employed author-developed measures of grief and support service satisfaction [70] the remaining quantitative studies employed standardised and validated measures for both predictors and grief [23–25, 67, 76, 84, 86–96].”

    From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [67]

    The Methods > Measures section says participants completed standardized instruments, including the Perinatal Grief Scale, and used items from the Duke University Religion Index to assess religious activity. But pregnancy management choices were collected with the Pregnancy History and Choices Questionnaires, which the authors say were developed specifically for this project; the claim that predictors were uniformly measured with standardized, validated instruments is therefore not supported for this study. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In nine of 10 studies which compared men and women, men's grief scores were significantly lower or less intense than those of women.

    “In nine of 10 studies which compared men and women, men’s grief scores were significantly lower or less intense than those of women [67, 94, 96].”

    From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [67]

    The Results (Psychological outcome; page not provided) report significantly higher grief scores among women than men in this study. The paper does not report a comparison of ten studies or the claimed nine-of-ten count. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • In five quantitative studies, increasing gestational age was associated with higher grief scores.

    “In five quantitative studies, increasing gestational age was associated with higher grief scores [23–25, 67, 93].”

    From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [67]

    The Results (Psychological outcome; page unavailable) report higher active-grief scores among men whose partners terminated in the second trimester than among those whose partners terminated in the first. The paper does not establish this association for women or count five studies with that finding; its Introduction says prior findings on gestational age were conflicting. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Thirteen included studies used the Perinatal Grief Scale (PGS) as a primary measure of grief.

    “Although 13 studies used the Perinatal Grief Scale (PGS) as a primary measure of grief”

    From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [67]

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Authors
Cope, H., Garrett, M. E., Gregory, S., & Ashley-Koch, A.
Affiliations
  • Duke Medical Center (US)
  • Center for Human Disease Modeling; Duke University Medical Center; Durham NC USA
Corresponding author
Cope, Heidi
ORCID
Venue
Prenatal Diagnosis
Publisher
Wiley
Published
2015-05-26
Volume
35
Issue
8
Pages
761-768
ISSN
0197-3851 (ISSN-L)
DOI
10.1002/pd.4603
PMC
PMC4968036
OpenAlex
W1792196047
Cited by
33
References
38
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 4 · 2018: 1 · 2017: 3 · 2016: 2
FWCI
2.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Prenatal Diagnosis (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (NS039818)
  • Genetic Counseling Foundation (n/a)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
abortion, continuation of pregnancy, anencephaly, neural tube defects, perinatal grief, post-traumatic stress, depression, religiosity, gender differences, psychological outcomes
MeSH terms
Abortion, Eugenic, Adaptation, Psychological, Adolescent, Adult, Anencephaly, Depression, Female, Fetal Death, Grief, Humans, Male, Pregnancy, Prenatal Diagnosis, Religion, Stress Disorders, Post-Traumatic, Logistic Models, Young Adult

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