BACKGROUND: Unexplained miscarriage is speculated to be due to a Th1/Th2 cytokine imbalance at the feto-maternal interface and immunological functions are known to be under the influence of various psychological factors. Indeed, the psycho-neuro-immuno-endocrine network has been proposed to contribute to miscarriage. To assess whether psychological disorders might induce spontaneous abortion we carried out a prospective study to determine if any psychological parameter influenced risk in those patients with a history of recurrent miscarriages. METHODS: A prospective study was carried out on 61 patients with a history of two consecutive first-trimester miscarriages. A battery of self-report questionnaires including Symptom Checklist-90 Revised and the NEO Five Factor Index and semi-structured interviews were conducted before a subsequent pregnancy. We investigated whether or not these parameters predicted subsequent miscarriages. RESULTS: Ten (22.2%) of the 45 patients who conceived miscarried again. Baseline depressive symptoms influenced subsequent miscarriage (P = 0.004). This statistically significant effect remained when we corrected with Bonfferoni adjustment (P = 0.036). CONCLUSIONS: A high depression scale is associated with a high miscarriage rate in those patients suffering recurrent miscarriage.
BACKGROUND: Unexplained miscarriage is speculated to be due to a Th1/Th2 cytokine imbalance at the feto-maternal interface and immunological functions are known to be under the influence of various psychological factors. Indeed, the psycho-neuro-immuno-endocrine network has been proposed to contribute to miscarriage. To assess whether psychological disorders might induce spontaneous abortion we carried out a prospective study to determine if any psychological parameter influenced risk in those patients with a history of recurrent miscarriages. METHODS: A prospective study was carried out on 61 patients with a history of two consecutive first-trimester miscarriages. A battery of self-report questionnaires including Symptom Checklist-90 Revised and the NEO Five Factor Index and semi-structured interviews were conducted before a subsequent pregnancy. We investigated whether or not these parameters predicted subsequent miscarriages. RESULTS: Ten (22.2%) of the 45 patients who conceived miscarried again. Baseline depressive symptoms influenced subsequent miscarriage (P = 0.004). This statistically significant effect remained when we corrected with Bonfferoni adjustment (P = 0.036). CONCLUSIONS: A high depression scale is associated with a high miscarriage rate in those patients suffering recurrent miscarriage.
Authors: Kimberly A Yonkers; Katherine L Wisner; Donna E Stewart; Tim F Oberlander; Diana L Dell; Nada Stotland; Susan Ramin; Linda Chaudron; Charles Lockwood Journal: Gen Hosp Psychiatry Date: 2009 Sep-Oct Impact factor: 3.238