The impact of perinatal loss on adjustment to subsequent pregnancy.

The current study compared the emotional adjustment of pregnant couples with and without a history of perinatal loss. Thirty-one pregnant women with a history of perinatal loss and 31 pregnant women with an unremarkable reproductive history were assessed between their 10th and 24th week of gestation. Partners were also recruited. Twenty-eight men were in the loss group and 23 men in the comparison group. Couples with a history of loss reported significantly more depressive symptomatology and pregnancy-specific anxiety than couples in the comparison group. Women reported more depressive symptomatology than men. Regression analyses revealed that for the group with a previous loss, depressive symptomatology was significantly associated with self-criticism, interpersonal dependency and number of previous losses. For the comparison group, depressive symptomatology was significantly associated dyadic adjustment. Pregnancy-specific anxiety of women with a previous loss was associated with their belief that their behavior affects fetal health; for women in the comparison group, pregnancy-specific anxiety was associated with the belief that health professionals' behavior affects fetal health. Implications for practice of health care professionals are discussed. The importance of early intervention to reduce distress is highlighted by the finding that alterations in mood are apparent in the early stages of pregnancy for both women and men who have experienced a previous perinatal loss. While carefully reducing personal responsibility for fetal health in women with a previous loss may reduce their pregnancy-specific anxiety, women with an unremarkable obstetrical history may benefit from an approach diminishing their perception of the power that medical staff has on fetal health.