The Sadness Sticks

Women stay depressed for many years after a miscarriage

(RxWiki News) After a miscarriage, many women experience depression and anxiety. These mental health problems can continue for many years, even after the mother gives birth to a healthy child, according to new research.

In a study of the relationship between miscarriages and depression, a team led by researchers at the University of Rochester Medical Center asked more than 13,000 pregnant women about their history of miscarriages and stillbirths. The researchers examined the women for symptoms of depression and anxiety both during and after pregnancy. While most of the women reported never having a miscarriage, about 21 percent reported have at least one miscarriage. A little over 100 of the women reported having at least one previous still birth.

According to lead researcher Emma Robertson Blackmore, Ph.D., assistant professor of Psychiatry at the University of Rochester Medical Center, the study's findings show that the birth of a healthy child does not solve the mental health problems women deal with after a miscarriage or stillbirth. These results are important, Blackmore notes, because previous pregnancy loss is often not appreciated as a risk factor for prenatal and postnatal depression as much as other factors such as family history of depression, stressful events in life, and lack of social support.

The researchers found that nearly 13 percent of women who had one previous miscarriage or stillbirth had depressive symptoms 33 months after giving birth to a healthy child. About 19 percent of women who had two previous losses showed symptoms of depression 33 months after giving birth to a healthy child.

Previous studies have shown that depression among mothers can negatively affect children and families. As such, Blackmore recommends providing targeted support for pregnant women who have lost a baby in the past. Doing so may improve health outcomes for both mothers and their children.

Each year, more than one million women in the United States experience a miscarriage or stillbirth. Anywhere from 50 to 80 percent of these women will become pregnant again.

Depression impacts an estimated 15 million adults in the United States. Depression is a state of prolonged low mood and aversion to activity. A person's thoughts, behavior, feelings and physical well-being are affected and may include feelings of sadness, anxiety, emptiness, hopelessness, worthlessness, guilt, irritability, or restlessness. The primary treatments for major depression are psychological counseling and medications. Medication therapies include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs). SSRIs include: fluoxetine (Prozac®), paroxetine (Paxil®), sertraline (Zoloft®), citalopram (Celexa®) and escitalopram (Lexapro®). SNRIs include: duloxetine (Cymbalta®), venlafaxine (Effexor®) and desvenlafaxine (Pristiq®). Bupropion (Wellbutrin) is an NDRI. Atypical antidepressants include trazodone (Desyrel®) and mirtazapine (Remeron®). Each medication category has different side effects.

The study by Dr. Blackmore and colleagues is published in the British Journal of Psychiatry.

Review Date: 
March 3, 2011