Threatened miscarriage and depressive and anxiety symptoms among women and partners in early pregnancy.

ABSTRACT

BACKGROUND: Antenatal depression has been associated with poor maternal and fetal outcomes, and threatened miscarriage is often seen clinically to impact adversely on maternal wellbeing, notwithstanding the limited research evidence. Our study aims to examine the link between threatened miscarriage and antenatal depression and anxiety in an Asian obstetric population. METHODS: We recruited 121 women and 68 partners facing threatened miscarriage, and 241 women and 180 partners experiencing uncomplicated pregnancies from a tertiary maternity hospital in Singapore. All participants completed a Patient Information Questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: The proportion of women with major depressive and anxiety symptomatology was significantly higher among women facing threatened miscarriage compared to those with stable pregnancies (depressive 33.1% vs. 17.0%, p = 0.008; anxiety 48.8% vs. 23.7%, p < 0.0001). Amongst their partners, there was a non-significant trend towards a similar finding (depressive 10.3% vs. 7.2%, p = 0.439; anxiety 23.5% vs. 18.9%, p = 0.478). Threatened miscarriage remained significantly associated with major depressive symptomatology after adjusting for potential confounders among women (OR 2.70; 95% CI 1.55, 4.71; p < 0.0001) but not among their partners (OR 1.47; 95% CI 0.56, 3.87; p = 0.430). LIMITATIONS: This study is limited by its cross-sectional design and relatively small sample size for male partners. CONCLUSION: Antenatal depressive and anxiety symptomatology affects one in four women in their first trimester, with even higher prevalence among women facing threatened miscarriage. Targeted depression and anxiety screening that includes women facing threatened miscarriages may facilitate early and efficient detection and management of mental health problems among pregnant women.