Differences in post‐traumatic stress, anxiety and depression following miscarriage and ectopic pregnancy between women and their partners: a multicenter prospective cohort study

Objectives To investigate and compare post-traumatic stress, depression and anxiety in women and their partners over a 9-month period following miscarriage or ectopic pregnancy. Methods This was a prospective cohort study. Consecutive women and partners were approached in the early pregnancy units of three hospitals in central London. One, three and nine months after early pregnancy loss, recruits were emailed links to surveys containing the Hospital Anxiety and Depression Scale (HADS) and Post-traumatic Diagnostic Scale (PDS). The proportion of participants meeting screening criteria for moderate/severe anxiety or depression and post-traumatic stress (PTS) was assessed. Mixed-effects logistic regression was used to analyse differences between women and their partners and the evolution over time. Results 386 partners were approached after the woman in whom the loss had been diagnosed consented to participate. 192 couples were recruited. All partners were male. Response rates were 57%, 45% and 38% for partners, and 76%, 68% and 57% for women, at month 1, 3 and 9 respectively. For partners, 7% met the criteria for PTS at month 1, 8% at month 3 and 4% at month 9, compared to 34%, 26% and 21%, respectively, of women. Partners also experienced lower rates of moderate/severe anxiety (6% vs 30% at month 1, 9% vs 25% at month 3, 6% vs 22% at month 9) and depression (2% vs 10% at month 1, 5% vs 8% at month 3, 1% vs 7% at month 9). The odds ratios for morbidity in partners vs women after 1 month was 0.02 (95% CI, 0.004-0.12) for post-traumatic stress, 0.05 (95% CI, 0.01-0.19) for moderate/severe anxiety and 0.15 (95% CI, 0.02-0.96) for moderate/severe depression. Morbidity for each outcome decreased modestly over time, without strong evidence of a different evolution for women and their partners. Conclusions Partners experience far lower levels of post-traumatic stress, anxiety and depression than women after early pregnancy loss. This article is protected by copyright. All rights reserved.