The DOI matches its Crossref record; 89 of the 89 references it cites were found in a registry or an index.
Psychological morbidity following miscarriage
Abstract
Emerging evidence has suggested that miscarriage could be associated with significant and possibly enduring psychological consequences. As many as 50% of miscarrying women suffer some form of psychological morbidity in the weeks and months after loss. About 40% of miscarrying women were found to be suffering from symptoms of grief shortly after miscarriage, and pathological grief can follow. Elevated anxiety and depressive symptoms are common, and major depressive disorder has been reported in 10-50% after miscarriage. Psychological symptoms could persist for 6 months to 1 year after miscarriage. The underlying risk factors predisposing a miscarrying woman to psychological morbidity include a history of psychiatric illness, childlessness, lack of social support or poor marital adjustment, prior pregnancy loss, and ambivalence toward the fetus. In addition, care-givers should be aware of the possible moderating effect of clinical practices such as surgical treatment and ultrasound findings on the psychological impact on a miscarrying woman. Unlike in postpartum depression, simple and effective screening measures of psychological morbidity in the context of miscarriage have not been well established. While studies have highlighted that psychological follow-up was highly desired by miscarrying women, and that psychological intervention was potentially beneficial, there is a substantial lack of randomized controlled intervention studies in this area.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A number of quantitative studies compared the grief responses of fathers and mothers after perinatal loss and found lower levels of grief intensity in the fathers.45-50”
From Complicated grief after perinatal loss (2012) · cites this paper as [46]
Citations
Cites
(1969) · Cited by 18,340
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962
Attachment and Loss. Vol. 1. Attachment
Rever, G. W. (1972) · Psychosomatic Medicine · doi:10.1097/00006842-197211000-00011 · Cited by 8,446
Attachment and Loss. Vol. I. Attachment.
Jones, N. B., & Bowlby, J. (1970) · Man · doi:10.2307/2798963 · Cited by 4,208
Maternal age and fetal loss: population based register linkage study
Andersen, A.-M. N. (2000) · BMJ · doi:10.1136/bmj.320.7251.1708 · Cited by 1,690
The Mourning Response of Parents to the Death of a Newborn Infant
Kennell, J. H., Slyter, H., & Klaus, M. H. (1970) · New England Journal of Medicine · doi:10.1056/nejm197008132830706 · Cited by 304
The Shatin Community Mental Health Survey in Hong Kong
Chen, C.-N. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820140051005 · Cited by 300
The Perinatal Grief Scale: Development and initial validation.
Toedter, L. J., Lasker, J. N., & Alhadeff, J. M. (1988) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1988.tb01604.x · Cited by 297
Miscarriage as a traumatic event: A review of the literature and new implications for intervention
Lee, C. W., & Slade, P. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00579-x · Cited by 253
Posttraumatic stress disorder after pregnancy loss
Engelhard, I. M., van den Hout, M. A., & Arntz, A. (2001) · General Hospital Psychiatry · doi:10.1016/s0163-8343(01)00124-4 · Cited by 245
SYSTEMIC TRAUMATIC STRESS: THE COUPLE ADAPTATION TO TRAUMATIC STRESS MODEL
Goff, B. S. N., & Smith, D. B. (2005) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2005.tb01552.x · Cited by 228
Support after perinatal death: a study of support and counselling after perinatal bereavement
Forrest, G. C., Standish, E., & Baum, J. D. (1982) · BMJ · doi:10.1136/bmj.285.6353.1475 · Cited by 221
Toedter, L. J., Lasker, J. N., & Janssen, H. J. E. M. (2001) · Death Studies · doi:10.1080/074811801750073251 · Cited by 207
Toedter, L. J., Lasker, J. N., & Janssen, H. J. E. M. (2001) · Death Studies · doi:10.1080/07481180125971 · Cited by 207
Lee, C. W., Slade, P., & Lygo, V. (1996) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1996.tb01849.x · Cited by 204
Major Depressive Disorder in the 6 Months After Miscarriage
Neugebauer, R. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540290035029 · Cited by 202
Self-citationSuicides after pregnancy in Finland, 1987–94: register linkage study
Gissler, M., Hemminki, E., & Lönnqvist, J. K. (1996) · BMJ · doi:10.1136/bmj.313.7070.1431 · Cited by 191
The Psychiatric Consequences of Spontaneous Abortion
Friedman, T., & Gath, D. (1989) · British Journal of Psychiatry · doi:10.1192/bjp.155.6.810 · Cited by 184
(1992) · Europe PMC (PubMed Central) · Cited by 167
Controlled prospective study on the mental health of women following pregnancy loss
(1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.2.226 · Cited by 165
Expectant, Medical, or Surgical Management of First-Trimester Miscarriage: A Meta-Analysis
Sotiriadis, A., Makrydimas, G., Papatheodorou, S., & Ioannidis, J. P. A. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000158857.44046.a4 · Cited by 158
Depressive symptoms in women in the six months after miscarriage
Neugebauer, R., Kline, J., O’Connor, P., Shrout, P., Johnson, J., Skodol, A., Wicks, J., & Susser, M. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(92)91839-3 · Cited by 158
Self-citationEffects of Caring, Measurement, and Time on Miscarriage Impact and Women's Well-Being
Swanson, K. M. (1999) · Nursing Research · doi:10.1097/00006199-199911000-00004 · Cited by 157
A Prospective Study of Risk Factors Predicting Grief Intensity Following Pregnancy Loss
Janssen, H. J. E. M. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830130062013 · Cited by 147
Beutel, M., Willner, H., Deckardt, R., Von Rad, M., & Weiner, H. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00520-x · Cited by 141
Grief and Depression After Miscarriage: Their Separation, Antecedents, and Course
Beutel, M., Deckardt, R., von Rad, M., & Weiner, H. (1995) · Psychosomatic Medicine · doi:10.1097/00006842-199511000-00003 · Cited by 140
Determinants of depressive symptoms in the early weeks after miscarriage.
Neugebauer, R., Kline, J. K., O’Connor, P. A., Shrout, P. E., Johnson, J. O., Skodol, A. E., Wicks, J., & Susser, M. W. (1992) · American Journal of Public Health · doi:10.2105/ajph.82.10.1332 · Cited by 139
Self-citationA three‐month follow‐up of psychological morbidity after early miscarriage
Ptettyman, R. J., Cordle, C. J., & Cook, G. D. (1993) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1993.tb01762.x · Cited by 131
THE RELATIONSHIP OF ATTACHMENT THEORY AND PERINATAL LOSS
Margaret Robinson, L. B. (1999) · Death Studies · doi:10.1080/074811899201073 · Cited by 131
Perinatal loss and parental bereavement
(1989) · American Journal of Psychiatry · doi:10.1176/ajp.146.5.635 · Cited by 124
Chung, T. K. H., Lee, D. T. S., Cheung, L. P., Haines, C. J., & Chang, A. M. Z. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00128-4 · Cited by 122
Righetti, P. L., Dell’avanzo, M., Grigio, M., & Nicolini, U. (2005) · British Journal of Psychology · doi:10.1348/000712604x15518 · Cited by 121
Brier, N. M. (2004) · Birth · doi:10.1111/j.0730-7659.2004.00292.x · Cited by 121
Parents' Grief following Pregnancy Loss: A Comparison of Mothers and Fathers
Stinson, K. M., Lasker, J. N., Lohmann, J., & Toedter, L. J. (1992) · Family Relations · doi:10.2307/584836 · Cited by 120
Vance, J. C., Boyle, F. M., Najman, J. M., & Thearle, M. J. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.167.6.806 · Cited by 113
Anxiety Disorders Following Miscarriage
Geller, P. A., Klier, C. M., & Neugebauer, R. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0606 · Cited by 110
Self-citationCouples' grief and experience of support in the aftermath of miscarriage
Conway, K., & Russell, G. (2000) · British Journal of Medical Psychology · doi:10.1348/000711200160714 · Cited by 106
The Parental–Foetal Relationship -a Comparison of Male and Female Expectant Parents
Condon, J. T. (1985) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674828509016729 · Cited by 106
Minor depressive disorder in the context of miscarriage
Klier, C. M., Geller, P. A., & Neugebauer, R. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00126-3 · Cited by 100
Self-citationCoping With Grief After Involuntary Pregnancy Loss: Perspectives of African American Women
Van, P., & Meleis, A. I. (2003) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1177/0884217502239798 · Cited by 97
Patterns of grief reaction after pregnancy loss.
Lin, S. X., & Lasker, J. N. (1996) · American Journal of Orthopsychiatry · doi:10.1037/h0080177 · Cited by 96
Miscarriage and stillbirth: time since the loss, grief intensity and satisfaction with care
Cuisinier, M. C. J., Kuijpers, J. C., Hoogduin, C. A. L., de Graauw, C. P. H. M., & Janssen, H. J. E. M. (1993) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0028-2243(93)90066-l · Cited by 95
The impact of perinatal loss on adjustment to subsequent pregnancy
Franche, R.-L., & Mikail, S. F. (1999) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00438-9 · Cited by 90
Cultural perspectives of grief: an expanded concept analysis
Cowles, K. V. (1996) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.1996.tb02669.x · Cited by 90
The legitimacy of grieving: The partner's experience at miscarriage
Puddifoot, J. E., & Johnson, M. P. (1997) · Social Science & Medicine · doi:10.1016/s0277-9536(96)00424-8 · Cited by 90
The grief response in the partners of women who miscarry
Johnson, M. P., & Puddifoot, J. E. (1996) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1996.tb01875.x · Cited by 89
(1984) · PubMed · Cited by 86
The effects of gestational age and gender on grief after pregnancy loss.
Goldbach, K. R. C., Dunn, D. S., Toedter, L. J., & Lasker, J. N. (1991) · American Journal of Orthopsychiatry · doi:10.1037/h0079261 · Cited by 84
UNDERSTANDING AND MANAGING THE EMOTIONAL REACTIONS TO A MISCARRIAGE
Brier, N. M. (1999) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(98)00294-4 · Cited by 82
Parents' perceptions of the miscarriage experience
Hutti, M. H. (1992) · Death Studies · doi:10.1080/07481189208252588 · Cited by 81
The experience of early miscarriage from a male perspective
Murphy, F. A. (1998) · Journal of Clinical Nursing · doi:10.1046/j.1365-2702.1998.00153.x · Cited by 80
Waard, M. W., Hartman, E. E., Ankum, W. M., Reitsma, J. B., Bindels, P., & Bonsel, G. J. (2002) · Human Reproduction · doi:10.1093/humrep/17.6.1638 · Cited by 76
Preliminary open trial of interpersonal counseling for subsyndromal depression following miscarriage
Neugebauer, R., Kline, J., Bleiberg, K., Baxi, L., Markowitz, J. C., Rosing, M., Levin, B., & Keith, J. (2007) · Depression and Anxiety · doi:10.1002/da.20150 · Cited by 73
Self-citationThe psychological implications of spontaneous abortions.
Seibel, M. J., & Wl, G. (1980) · PubMed · Cited by 73
Psychological outcomes following missed abortions and provision of follow‐up care
Nikcevic, A. V., Tunkel, S. A., & Nicolaides, K. H. (1998) · Ultrasound in Obstetrics & Gynecology · doi:10.1046/j.1469-0705.1998.11020123.x · Cited by 69
Psychological Distress Among Women With Recurrent Spontaneous Abortion
Klock, S. C., Chang, G., Hiley, A., & Hill, J. (1997) · Psychosomatics · doi:10.1016/s0033-3182(97)71428-2 · Cited by 68
Neugebauer, R., Kline, J., Markowitz, J. C., Bleiberg, K. L., Baxi, L., Rosing, M. A., Levin, B., & Keith, J. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0819 · Cited by 66
Self-citationPsychological reactions in women followed for 1 year after miscarriage
Robinson, G. E., Stirtzinger, R. M., Stewart, D. E., & Ralevski, E. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408865 · Cited by 66
Maternal grieving response after perinatal death
Nicol, M. T., Tompkins, J. R., Campbell, N. A., & Syme, G. J. (1986) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1986.tb128375.x · Cited by 66
The psychologic effects of spontaneous abortion.
(1989) · Europe PMC (PubMed Central) · Cited by 61
Cognitive processes in psychological adaptation to miscarriage: A preliminary report
Tunaley, J. R., Slade, P., & Duncan, S. L. B. (1993) · Psychology and Health · doi:10.1080/08870449308401929 · Cited by 57
Neugebauer, R. (2003) · Depression and Anxiety · doi:10.1002/da.10019 · Cited by 57
Self-citationWomen's experiences of general practitioner management of miscarriage.
Friedman, T. (1989) · PubMed · Cited by 54
Lee, D. T. S., Cheung, L. P., Haines, C. J., Chan, K., & Chung, T. K. H. (2001) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2001.117661 · Cited by 51
The Maternity Blues in Post-partum and Post-operative Women
Levy, V. (1987) · The British Journal of Psychiatry · doi:10.1192/bjp.151.3.368 · Cited by 51
Transforming loss: Taiwanese women's adaptation to stillbirth
Hsu, M., Tseng, Y., & Kuo, L. (2002) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2002.02386.x · Cited by 51
The Experience and Psychological Impact of Early Miscarriage
Jackman, C., McGee, H. M., & Turner, M. J. (1991) · The Irish Journal of Psychology · doi:10.1080/03033910.1991.10557831 · Cited by 50
Evaluation of a perinatal grief support team
Lake, M. F., Johnson, T. M., Murphy, J., & Knuppel, R. A. (1987) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(87)80295-8 · Cited by 48
Miscarriage: Women's views of care
Cecil, R. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408864 · Cited by 47
Psychological Repercussions of Pregnancy Loss
Herz, E. K. (1984) · Psychiatric Annals · doi:10.3928/0048-5713-19840601-11 · Cited by 46
Acute and post-traumatic stress disorder after spontaneous abortion.
Bowles, S. V., James, L., Ds, S., Yancey, M. K., Epperly, T. D., Folen, R. A., & Masone, M. (2000) · PubMed · Cited by 45
Towards a preliminary framework for understanding pregnancy loss
Moulder, C. (1994) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839408408869 · Cited by 43
Perinatal Bereavement Grief Scale: Distinguishing Grief From Depression Following Miscarriage
Ritsher, J. B., & Neugebauer, R. (2002) · Assessment · doi:10.1177/1073191102009001005 · Cited by 43
Self-citationSpontaneous Abortion: Short‐term Complications Following Either Conservative or Surgical Management
Chung, T. K. H., Cheung, L. P., Sahota, D. S., Haines, C. J., & Chang, A. M. Z. (1998) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.1998.tb02960.x · Cited by 43
Early miscarriage: Preliminary results from a study in Northern Ireland
Cecil, R., & Leslie, J. C. (1993) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839308403199 · Cited by 42
Grief reactions to perinatal death: An exploratory study
Laroche, C., Lalinec-Michaud, M., Engelsmann, F. F., Fuller, N., Copp, M., & Vasilevsky, K. (1982) · Psychosomatics · doi:10.1016/s0033-3182(82)73383-3 · Cited by 41
Screening Psychiatric Morbidity After Miscarriage
Lee, D. T. S., Wong, C. K., Ungvari, G. S., Cheung, L. P., Haines, C. J., & Chung, T. K. H. (1997) · Psychosomatic Medicine · doi:10.1097/00006842-199703000-00014 · Cited by 37
Psychiatric morbidity following miscarriage: a prevalence study of Chinese women in Hong Kong
Lee, D. T. S., Wong, C. K., Cheung, L. P., Leung, H. C. M., Haines, C. J., & Chung, T. K. H. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(96)01418-8 · Cited by 37
Major depressive disorder in the 6 months after miscarriage
Neugebauer, R. (1997) · JAMA · doi:10.1001/jama.277.5.383 · Cited by 33
Self-citationSpontaneous abortion and grieving.
Jm, S. (1980) · PubMed · Cited by 32
Screening for post-miscarriage psychiatric morbidity
Lok, I. H., Lee, D. T. S., Yip, S., Shek, D. T. L., Tam, W. H., & Chung, T. K. H. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.01.003 · Cited by 28
Self-citationIsrael's doctors end their strike
Siegel-Itzkovich, J. (2000) · BMJ · doi:10.1136/bmj.321.7255.198/e · Cited by 23
Bereavement and grieving after spontaneous abortion.
Rosenfeld, J. A. (1991) · PubMed · Cited by 23
The experience of miscarriage: how couples define quality in health care delivery.
Speraw, S. (1994) · PubMed · Cited by 22
Weiss, L., Frischer, L., & Richman, J. (1989) · Clinics in Perinatology · doi:10.1016/s0095-5108(18)30618-3 · Cited by 21
Frankel, F. H. (1965) · Archives of Environmental Health An International Journal · doi:10.1080/00039896.1965.10664308 · Cited by 17
Consensus in the Marital Dyad: Couples' Perceptions of Contraception, Communication, and Family Life
Neal, A. G., & Groat, H. T. (1976) · Sociological Focus · doi:10.1080/00380237.1976.10570940 · Cited by 16
Conway, K. (1992) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674829209019575 · Cited by 10
It might have been: Mourning the unborn
Cole, D. (1987) · PsycEXTRA Dataset · doi:10.1037/e400842009-007 · Cited by 1
Flagged first, then by citations
Research works printed but not linked: 4
- Hammerslough, 1992, Estimating the probability of spontaneous abortion in the presence of induced abortion and vice versa, Public Health Rep, 107, 269
- Lok IH. Psychological morbidity after miscarriage. M.D. Thesis. The Chinese University of Hong Kong, in press.
- Garel, 1992, Depressive reaction after miscarriage, Contracept Fertil Sex, 20, 75
- Kirkley-Best, 1981, Grief in response to prenatal loss: an argument for the earliest maternal attachment, Diss Abstr Int, 42, 2560
Cited by
Sorted by citations
Complicated grief after perinatal loss
Kersting, A., & Wagner, B. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/akersting · Cited by 419
de Jong, P. G., Kaandorp, S., Di Nisio, M., Goddijn, M., & Middeldorp, S. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004734.pub4 · Cited by 204
Robinson, G. E. (2013) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2013.08.012 · Cited by 142
Experience of miscarriage: an interpretative phenomenological analysis
Meaney, S., Corcoran, P., Spillane, N., & O'Donoghue, K. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-011382 · Cited by 136
“7–14 These studies also report that the high levels of stress and anxiety experienced can endure for 6–12 months following miscarriage.(8) In contrast, an interventional study in the”
Swanson, K. M., Chen, H.-T., Graham, J. C., Wojnar, D. M., & Petras, A. (2009) · Journal of Women's Health · doi:10.1089/jwh.2008.1202 · Cited by 131
Metadata
- Authors
- Lok, I. H., & Neugebauer, R.
- Affiliations
- Chinese University of Hong Kong (HK)
- New York State Psychiatric Institute (US)
- Corresponding author
- Lok, Ingrid H.
- Venue
- Best Practice & Research Clinical Obstetrics & Gynaecology
- Publisher
- Elsevier BV
- Published
- 2007-04
- Volume
- 21
- Issue
- 2
- Pages
- 229-247
- ISSN
- 1521-6934 (ISSN-L)
- OpenAlex
- W2167519625
- Cited by
- 302
- References
- 88
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 13 · 2023: 35 · 2022: 19 · 2021: 17 · 2020: 20 · 2019: 16 · 2018: 14 · 2017: 19 · 2016: 15 · 2015: 18 · 2014: 20 · 2013: 14 · 2012: 15
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- miscarriage, psychological morbidity, grief, pathological grief, major depressive disorder, anxiety, risk factors, social support, marital adjustment, childlessness, psychological screening, psychological intervention, ultrasound findings, surgical treatment
- MeSH terms
- Abortion, Spontaneous, Female, Grief, Humans, Pregnancy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review