The DOI matches its Crossref record; 42 of the 46 references it cites were found in a registry or an index; 3 of the 21 sources its claims cite were checked for support.
Previous prenatal loss as a predictor of perinatal depression and anxiety
Open accessAbstract
BACKGROUND: Prenatal loss, the death of a fetus/child through miscarriage or stillbirth, is associated with significant depression and anxiety, particularly in a subsequent pregnancy. AIMS: This study examined the degree to which symptoms of depression and anxiety associated with a previous loss persisted following a subsequent successful pregnancy. METHOD: Data were derived from the Avon Longitudinal Study of Parents and Children cohort, a longitudinal cohort study in the west of England that has followed mothers from pregnancy into the postnatal period. A total of 13,133 mothers reported on the number and conditions of previous perinatal losses and provided self-report measures of depression and anxiety at 18 and 32 weeks' gestation and at 8 weeks and 8, 21 and 33 months postnatally. Controls for pregnancy outcome and obstetric and psychosocial factors were included. RESULTS: Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P<0.01) and anxiety (β = 0.14, s.e. = 0.05, P<0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors. This association remained constant across the pre- and postnatal period, indicating that the impact of a previous prenatal loss did not diminish significantly following the birth of a healthy child. CONCLUSIONS: Depression and anxiety associated with a previous prenatal loss shows a persisting pattern that continues after the birth of a subsequent (healthy) child. Interventions targeting women with previous prenatal loss may improve the health outcomes of women and their children.
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Claims the paper makes
8 Own result · 6 Own method · 4 No full text of the sources · 2 Partly supported · 2 Own interpretation · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Prenatal loss, the death of a fetus/child through miscarriage or stillbirth, is associated with significant depression and anxiety, particularly in a subsequent pregnancy.”
- Also stated in: § Conclusions · plain
“Women exhibit significantly elevated levels of depression and anxiety in the weeks and months following the loss, compared with samples of pregnant, community or postpartum women.5–10”
- Also stated in: § Conclusions · boosted
“women with a history of prenatal loss are consistently reported to exhibit significantly elevated rates of anxiety and depressive symptoms during a subsequent pregnancy.14–18”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Background
What the sources say
- Not matchedcites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [6] source
- Partly supportedcites [7] sourceExperimental — accuracy not yet measured
The Introduction says the cohort included women with a previous stillbirth or late miscarriage, and the Discussion reports significantly higher depression and state anxiety in the third trimester of their subsequent pregnancy. The claim is broader than the study: participants’ losses occurred after 18 weeks’ gestation, so it does not establish the association for earlier miscarriages. The Discussion also says the elevation was concentrated among women who conceived within 12 months of the loss. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [8]
- Not checked — no full text of the sourcecites [9] source
- Not matchedcites [10]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [14] source
- Not checked — no full text of the sourcecites [15] source
- Not checked — no full text of the sourcecites [16] source
- Not checked — no full text of the sourcecites [17] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Conclusions · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This association remained constant across the pre- and postnatal period”
- Also stated in: § Results · plain
“For neither depressive nor anxiety symptoms was there an interaction between time of assessment and prenatal loss; that is, the association between prenatal loss and depressive and anxiety symptoms was not significantly different across the pre- and postnatal assessments”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results indicated that the difference between stillbirth and miscarriage was not significant (P = 0.27).”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P < 0.01) and anxiety (β = 0.14, s.e. = 0.05, P < 0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Results
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The set of covariates included in the models adequately controls for confounding of the association between previous prenatal loss and depressive/anxiety symptoms.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P < 0.01) and anxiety (β = 0.14, s.e. = 0.05, P < 0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Results
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The set of covariates included in the models adequately controls for confounding of the association between previous prenatal loss and depressive/anxiety symptoms.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“for each additional prenatal loss there was a corresponding increase of approximately one-quarter of a standard deviation in mood symptoms.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Self-reports of prenatal loss may be underestimated insofar as mothers are often unaware of spontaneous early miscarriages.4”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Strengths and limitations
What the sources say
- Not checked — no full text of the sourcecites [4] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants were asked about the number of miscarriages and stillbirths experienced retrospectively, which could be subject to recall bias.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“indicating that the impact of a previous prenatal loss did not diminish significantly following the birth of a healthy child.”
- Also stated in: § Main findings · plain
“We found no evidence that affective symptoms associated with previous prenatal loss resolve with the birth of a healthy child.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Birth weight and gestational age adequately index the birth of a healthy child.
- Also stated in: § Main findings · plain
- Probably not a substantial claim. 11
- It may state two separate claims as one. 7
- The quote only partly states this claim. 1
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“which in turn has deleterious effects on maternal–child attachment, child behaviour, and cognitive and neuroendocrine outcomes that persist into adolescence.36–40”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Clinical implications
What the sources say
- Not checked — no full text of the sourcecites [36] source
- Partly supportedcites [37] sourceExperimental — accuracy not yet measured
The section on antenatal anxiety and behavioural/emotional problems identifies postnatal depression as a known risk factor for children's behavioural/emotional problems. It does not establish effects on maternal–child attachment or cognitive and neuroendocrine outcomes, nor persistence into adolescence; this study assessed child outcomes at 47 months (Method). (LLM, conf=0.88)
- Could not verifycites [38] sourceExperimental — accuracy not yet measured
The Interviews and Interview data sections (page not available) examine grief after stillbirth and report that the women did not develop debilitating depression. A search for maternal–child attachment, child behaviour, cognitive or neuroendocrine outcomes, and effects persisting into adolescence found no passage addressing those effects of postpartum depression. (LLM, conf=0.78)
- Not checked — no full text of the sourcecites [39] source
- Not checked — no full text of the sourcecites [40] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found substantively comparable results using this alternate scaling.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results > Supplementary analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It was not. The association between prenatal loss and anxious symptoms was confounded by the association between prenatal loss and depressive symptoms and the high degree of covariation between anxious and depressive symptoms (>r = 0.70 at each assessment).”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results > Supplementary analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results indicate that, as expected, many of the psychosocial and sociodemographic covariates were associated with depressive and anxiety symptom scores.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Controls for pregnancy outcome and obstetric and psychosocial factors were included.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Abstract > Method
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, as noted, we were unable to assess the impact of time since loss as a potential predictor of postpartum mood.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Ethical approval for all measures was obtained from the ALSPAC Ethics and Law Committee and from local research ethics committees.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Method > Study population
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Maternal anxiety at each occasion was measured using the anxiety items from the Crown–Crisp Experiential Index (CCEI), a validated self-rating inventory.21 It has been shown to correlate with the State (0.70) and Trait (0.76) subscales of the Spielberger State–Trait Anxiety Inventory.22”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Method > Measures
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report questionnaire that has been extensively used and shown to be valid in and outside the postnatal period.23”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Method > Measures
What the sources say
- Not checked — no full text of the sourcecites [23] source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Accordingly, the current study is able to assess the psychological impact of prenatal loss, but is not positioned to examine biological hypotheses that there may be risk underlying both prenatal loss and the experience of depressive and anxiety symptoms.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Strengths of the study include the large community sample and detailed and repeated assessments of depressive and anxiety symptoms in the prenatal and postnatal period; the follow-up well past the postnatal period is a particular novelty in this area of study.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The current findings underscore the view that pregnancy and childbirth are major life events, a careful assessment of which may reveal information of value in understanding psychiatric morbidity.”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Findings from other studies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The quote only partly states this claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Both prenatal depression and anxiety are among the biggest predictors of postpartum depression,34,35”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Discussion > Clinical implications
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
The set of covariates included in the models adequately controls for confounding of the association between previous prenatal loss and depressive/anxiety symptoms.
“Controls for pregnancy outcome and obstetric and psychosocial factors were included.”
The authors state this as an assumption.
The missing data are missing at random.
“The impact of missing data was characterised by model estimates through two well-established missing data mechanisms: the missing completely at random assumption and the missing at random assumption.26”
The authors state this as an assumption.
Birth weight and gestational age adequately index the birth of a healthy child.
“The current study extends this work by showing that the impact persists well past the subsequent pregnancy and despite the birth of a healthy child (indexed here by birth weight and gestational age of the subsequent child).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Method > Measures
“A cut-off score of ≥ 12 is recommended to identify cases of probable major depression.24”
§ Previous prenatal loss as a predictor of perinatal depression and anxiety > Results
“Table 2 shows the percentage and number of women who scored greater than 12 on the EPDS, which is indicative of a case of probable major depression, grouped by the number of losses.”
Citations
Cites
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“Other predictors of PPD include stressful life events (O'Hara & Swain, 1996), an unwanted or unplanned pregnancy (Beck, 2001), and a previous miscarriage or stillbirth (Blackmore et al., 2011).”
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Providing Supportive Psychosocial Care to Parents after Perinatal Loss
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“Due to the important role of stress in pregnancy, it is essential to have psychological interventions targeting women with previous miscarriages or stillbirths to improve maternal and neonatal outcomes ([20]).”
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Client Attachment in Therapy for Recurrent Pregnancy Loss and Infertility
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Endocrine causes of recurrent pregnancy loss in patients with post-traumatic stress disorder
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Influential
Metadata
- Authors
- Blackmore, E. R., Côté-Arsenault, D., Tang, W., Glover, V., Evans, J., Golding, J., & O'Connor, T. G.
- Affiliations
- University of Rochester Medicine (US)
- Imperial College London (GB)
- University of Bristol (GB)
- Corresponding author
- Blackmore, Emma Robertson
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2011-05
- Volume
- 198
- Issue
- 5
- Pages
- 373-378
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC3084335
- OpenAlex
- W2117946497
- Cited by
- 315
- References
- 46
- Citations by year
- 2026: 23 · 2025: 27 · 2024: 25 · 2023: 43 · 2022: 18 · 2021: 21 · 2020: 17 · 2019: 19 · 2018: 16 · 2017: 18 · 2016: 18 · 2015: 20 · 2014: 21 · 2013: 14 · 2012: 11
- FWCI
- 15.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- Wellcome Trust (092731)
- University of Bristol
- National Institutes of Health
- Medical Research Council
- National Institute of Mental Health (R01MH073842, K23MH080290)
- 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 › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Keywords
- miscarriage, stillbirth, perinatal depression, perinatal anxiety, subsequent pregnancy, maternal mental health, Avon Longitudinal Study of Parents and Children
- MeSH terms
- Abortion, Spontaneous, Adolescent, Adult, Alcohol Drinking, Anxiety, England, Epidemiologic Methods, Female, Humans, Infant, Middle Aged, Mother-Child Relations, Mothers, Pregnancy, Smoking, Depression, Postpartum, Postpartum Period, Stillbirth, Young Adult
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