The goal of this research is to improve mental health care and outcomes of bereaved mothers after stillbirth and infant death. For every 100 live births in the United States, 1-2 mothers have a pregnancy complicated by a stillbirth or infant death, and African-American mothers are at particularly high risk. These devastating events are typically traumatic and life-altering experiences which put surviving parents at high risk for prolonged grief and psychiatric complications in the subsequent years. Little is known about the long-term mental health impact of perinatal loss on surviving mothers. In addition, while more than 70% of bereaved mothers are pregnant again within a year after a stillbirth, it is not known how mental health changes due to bereavement affect subsequent prenatal health behaviors or pregnancy outcomes after the loss. The proposed research utilizes both a longitudinal data analysis and a multi-year mail survey of bereaved and non-bereaved mothers. Study A links maternal and fetal/infant health datasets over 10 years following fetal or infant death to examine mental and physical health disorders, health care costs and utilization in subsequent years, and risk of new onset maternal mental illness. Study B will survey bereaved mothers and non-bereaved controls longitudinally to gather information about mental health and treatment over time, physical health, grief and bereavement, hospital care at the time of loss, and reproductive health and health behaviors during subsequent pregnancies.

Public Health Relevance

While fetal/infant death is uncommon, it still affects more than one mother out of 100 and can profoundly impact bereaved mothers and may impact the outcomes of their subsequent pregnancies as well. Findings from this research may potentially help to identify populations of women at highest risk for mental illness after a traumatic loss, measure the impact of hospital care on maternal psychiatric morbidity, quantify the economic costs of maternal health care in the years following a loss, and improve fetal outcomes in subsequent pregnancies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH085882-04
Application #
8368261
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Chavez, Mark
Project Start
2009-12-28
Project End
2014-11-30
Budget Start
2012-12-01
Budget End
2014-11-30
Support Year
4
Fiscal Year
2013
Total Cost
$165,464
Indirect Cost
$12,257
Name
University of Michigan Ann Arbor
Department
Family Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Gold, Katherine J; Abdul-Mumin, Abdul-Razak S; Boggs, Martha E et al. (2014) Assessment of "fresh" versus "macerated" as accurate markers of time since intrauterine fetal demise in low-income countries. Int J Gynaecol Obstet 125:223-7
Gold, Katherine J; Spangenberg, Kathryn; Wobil, Priscilla et al. (2013) Depression and risk factors for depression among mothers of sick infants in Kumasi, Ghana. Int J Gynaecol Obstet 120:228-31
Gold, Katherine J; Sen, Ananda; Schwenk, Thomas L (2013) Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry 35:45-9
Gold, Katherine J; Boggs, Martha E; Mugisha, Emeline et al. (2012) Internet message boards for pregnancy loss: who's on-line and why? Womens Health Issues 22:e67-72
Gold, Katherine J; Leon, Irving; Chames, Mark C (2010) National survey of obstetrician attitudes about timing the subsequent pregnancy after perinatal death. Am J Obstet Gynecol 202:357.e1-6
Gold, Katherine J; DeMonner, Sonya M; Lantz, Paula M et al. (2010) Prematurity and low birth weight as potential mediators of higher stillbirth risk in mixed black/white race couples. J Womens Health (Larchmt) 19:767-73
Dalton, Vanessa K; Harris, Lisa H; Gold, Katherine J et al. (2010) Provider knowledge, attitudes, and treatment preferences for early pregnancy failure. Am J Obstet Gynecol 202:531.e1-8
Lancaster, Christie A; Gold, Katherine J; Flynn, Heather A et al. (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 202:5-14
Gold, Katherine J; Sen, Ananda; Hayward, Rodney A (2010) Marriage and cohabitation outcomes after pregnancy loss. Pediatrics 125:e1202-7