The association between history of prenatal loss and maternal psychological state in a subsequent pregnancy: an ecological momentary assessment (EMA) study. Issue 3 (15th February 2023)

• Record Type: Journal Article
• Authors: Lazarides, Claudia; Moog, Nora K.; Verner, Glenn; Voelkle, Manuel C.; Henrich, Wolfgang; Heim, Christine M.; Braun, Thorsten; Wadhwa, Pathik D.; Buss, Claudia; Entringer, Sonja
• Is Part Of: Psychological medicine. Volume 53:Issue 3(2023)
• Page Start: 855
• Page End: 865
• Publication Date: 2023-02-15
• Subjects: Ecological momentary assessment -- linear mixed modeling -- mood -- pregnancy -- prenatal loss -- stress; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291721002221
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life. Method: This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models. Results: Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group. Conclusion: Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.