Authors: Armstrong, Deborah S.¹; Hutti, Marianne H.²; Myers, John³

Source: Journal of Obstetric, Gynecologic, & Neonatal Nursing, Volume 38, Number 6, November/December 2009 , pp. 654-666(13)

Publisher: Wiley-Blackwell

Abstract:

Objective:

To evaluate the long-term influence of a previous perinatal loss on parents' psychological distress during a subsequent childbearing experience. Design and Sample:

A cohort design was used to examine 36 couples with a history of prior perinatal loss. Data were collected during the third trimester of pregnancy, 3 months postpartum, and again 8 months after birth. Measures:

Outcome measures included posttraumatic stress (The Impact of Event Scale), depressive symptoms (Center for Epidemiologic Studies-Depression Scale), anxiety (Spielberger State-Trait Anxiety Inventory), and parental concerns and attitudes (Maternal/Paternal Attitudes Questionnaire). Results:

Levels of depressive symptoms (p<.001), anxiety (p<.001), and posttraumatic stress (p=.046) significantly decreased over time in this population. However, levels of posttraumatic stress remained in the moderate range even at 8 months after birth. Depression was significantly correlated with posttraumatic stress at each time point. In addition, depression was significantly related to posttraumatic stress, anxiety, and concerns parents had about their infant's well-being at T3. Conclusion:

While levels of anxiety and depressive symptoms decreased for parents who have experienced a previous perinatal loss, posttraumatic stress levels remained moderately high. It is unclear how this compares to parents without losses. These may be the unique symptoms and concerns these parents have about their new infant. Parents with a history of prior loss should have assessments carefully tailored to their experiences to anticipate continued psychological distress.

Keywords: perinatal loss; posttraumatic stress; depressive symptoms; parent-infant attachment

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1552-6909.2009.01069.x

Affiliations: 1: PhD, RN, is an associate professor in the School of Nursing, University of Louisville, Louisville, KY. 2: DNS, WHNP-BC, is a professor in the School of Nursing, University of Louisville, Louisville, KY. 3: PhD, MSPH, is an assistant professor in the Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY.

Publication date: 2009-11-01

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