You are here: iPSYCH Newsletter News Issue no. 1 Late miscarriages and stillbirths cause mothers to become psychologically vulnerable

Late miscarriages and stillbirths cause mothers to become psychologically vulnerable

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Trine Munk-Olsen, Senior Researcher, National Centre for Register-based Research, Aarhus University

Losing an unborn baby is a traumatic experience, and many women who go through this have to be admitted to psychiatric treatment. Such are the results of a new study from Aarhus University.

For most women, being pregnant and giving birth are joyful experiences, and most are in a mentally balanced state when they plan to have a baby.

But the trauma incurred by a miscarriage late in the pregnancy or giving birth to a stillborn is so severe that a lot of these women have to go into hospital or receive outpatient treatment shortly after the loss. These are the results of a new register-based study from Aarhus University, where researchers from the National Centre for Register-Based Research and MEPRICA have examined women’s contact with the psychiatric system in the period following an involuntary termination of pregnancy or stillbirth.

“From previous research, we know that loss generally increases the risk of developing mental illness, and our study then underlines the fact that a miscarriage or stillbirth is so traumatic that, especially in the first month after the loss, there is a significant or increased risk that the woman may need either outpatient treatment or to be admitted,” explains senior researcher Trine Munk Olsen.

The first month is the most vulnerable period

The increased risk of mental illness was measured by the number of contacts made with the psychiatric system, both for ambulant treatment or actual admissions. Almost 1400 women were diagnosed with at least one psychiatric illness over the course of the follow-up on the study, which ran from one year before the loss of the child to one year after. The most common mental conditions are transitional problems in the form of stress and adjustment disorders. The risk is greatest within the first month following the loss, whereas there is no increased risk in the months prior to the loss.

“We assume that this is just the top of the iceberg, since our study only incorporates information from the psychiatric system and does not consider the extent of the consumption of antidepressants or the extent to which these women consult private psychologists, their own doctors or self-help groups,” says Trine Munk Olsen.

The older the foetus, the greater the loss

The results have shown that the risk of being diagnosed with a mental disorder was greater among the women who lost their foetus after the 20th week of pregnancy. In other words, the older the foetus is when the miscarriage takes place, the greater the risk that the mother will subsequently develop a mental disorder.

These women, then, are a vulnerable group that need special attention from the healthcare system. But according to Trine Munk Olsen, the Danish healthcare system already focuses on this particular group through e.g. special precautionary measures to support the group of women who are facing giving birth to a dead child or going through a late miscarriage.

The article “Psychiatric disorders following fetal death: a population-based study” was recently published in the scientific journal BMJ Open.

Facts about the study 

  • The cohort study is based on data derived from the Danish population registers, which contain information about e.g. family demographics, income, education and contact with the healthcare system. The data dates all the way back to the 1960s.
  • The study examines the increase of first-time psychiatric patients among Danish women who have miscarried or given birth to a stillborn baby. The study is focused on the time period from 12 months before to 12 months after an involuntary termination of pregnancy.
  • The study includes over one million Danish women (born between 1960 and 1995). Between 1996 and 2010, almost 90,000 women miscarried or lost a baby for various reasons.
  • The calculations show that the risk of developing a mental disorder following a miscarriage or stillbirth increases the older the foetus is. The women seem to be most vulnerable immediately following the loss.
  • It is not yet clear whether the loss of a child is a triggering factor for mental illness, or whether a non-diagnosed mental illness may cause the foetus to be born prematurely.

Further information

Senior researcher Trine Munk-Olsen, Aarhus University, Department of Economics and Business, National Centre for Register-Based Research and MEPRICA, Mobile: +45 4013 8841, Office: +45 8716 5749, tmo@econ.au.dk

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