The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: a meta-analysis
Open accessAbstract
Background Research indicates perinatal loss is associated with anxiety, depression and stress in women and partners during subsequent pregnancies. However, there are no robust estimates of anxiety, depression and stress for this group. We meta-analytically estimated rates of anxiety, depression and stress in pregnant women and their partners during pregnancies after previous perinatal loss. Methods Databases (Medline, PsychInfo, Embase, Cinahl Plus) and grey literature were searched from 1995 through to May 2016. Search terms included: depression, anxiety, or stress with perinatal loss (miscarry*, perinatal death, spontaneous abortion, fetal death, stillbirth, intrauterine death, TOPFA) and subsequent pregnancy. Case-controlled, English-language studies using validated measures of anxiety, depression or stress in women or partners during pregnancy following perinatal loss were included. Data for effect sizes, study and demographic data were extracted. Results We identified nineteen studies representing n = 5114 women with previous loss; n = 30,272 controls; n = 106 partners with previous perinatal loss; and n = 91 control men. Random effects modelling demonstrated significant effects of perinatal loss on anxiety (d = 0.69, 95% CI = 0.41-0.97) and depression (d = 0.22, 95% CI = 0.15-0.30) in women; but no effect on stress (d = - 0.002, 95% CI = - 0.0639 to 0.0605). Limitations This study was limited by the quality of available studies, underpowered moderator analyses and an inability to examine additional covariates. Insufficient data were available to generate reliable effects for psychological distress in partners. Conclusions Our findings confirm elevated anxiety and depression levels during pregnancies following perinatal loss. Further research on predictors of distress in women and their partners is required.
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Anxiety and depression have been demonstrated in a subsequent pregnancy, with almost twice the odds of experiencing sadness or low mood and excessive worry compared with women without a previous loss.
“Anxiety and depression have also been demonstrated in a subsequent pregnancy, with almost twice the odds of experiencing sadness or low mood and excessive worry, compared with those women without a previous loss.5,6”
From Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study (2020) · cites this paper as [5]
The sections on anxiety and depression in women during pregnancy following perinatal loss report higher levels of both in subsequent pregnancies compared with controls. They report standardized effect sizes (d = 0.69 for anxiety; d = 0.22 for depression), not almost twice the odds of sadness or low mood and excessive worry, so the claimed magnitude and symptom-specific wording are not supported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMethodological, demographic and sampling differences hamper the ability to make precision estimates of the mental health sequelae of perinatal loss.
“This is a similar observation to review findings for the impact of perinatal loss on mental health in subsequent pregnancies (Hunter et al., 2017) but does suggest that methodological, demographic and sampling differences hamper the ability to make precision estimates of the mental health sequelae of perinatal loss.”
From The mental health impact of perinatal loss: A systematic review and meta-analysis (2022) · cites this paper as Hunter et al., 2017
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References 58 · Cited by 153
Research works printed but not linked: 26
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- Authors
- Hunter, A., Tussis, L., & MacBeth, A.
- Affiliations
- University of Edinburgh (GB)
- Corresponding author
- MacBeth, Angus
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 223
- Pages
- 153-164
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2735019230
- Cited by
- 153
- References
- 58
- Citations by year
- 2026: 20 · 2025: 11 · 2024: 19 · 2023: 32 · 2022: 17 · 2021: 16 · 2020: 19 · 2019: 10 · 2018: 8 · 2017: 1
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc-nd)
- Funders
- University of Leicester
- University of Oxford
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- perinatal loss, subsequent pregnancy, anxiety, depression, stress, psychological distress, miscarriage, stillbirth, fetal death, intrauterine fetal death, maternal mental health
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Female, Fetal Death, Humans, Pregnancy, Sexual Partners, Stress, Psychological, Pregnant Women, Pregnant People
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