The purpose of this study is to evaluate the influence of previous perinatal loss on parents' emotional distress during and after the birth of a subsequent healthy infant. Perinatal loss includes fetal death (early or late) or neonatal death within the first 28 days of life. Such losses are traumatic events in the lives of families and may have long-term consequences for the psychological health of parents. Pregnancies subsequent to loss can be stressful for both parents. Expectant mothers and fathers frequently experience apprehension about the outcome of the current pregnancy that oftentimes leads to depression and anxiety. It is unclear whether increased psychological distress during subsequent pregnancies continues after the birth of a healthy infant.
The specific aims of this study are to: 1) Determine whether mothers' and fathers' depressive symptoms, anxiety, quality of intimate partner relationships, concerns about their infant, and healthcare utilization vary by parent gender and prior loss experience over the course of late pregnancy through the first six months postpartum, and 2) Evaluate the impact of a prior perinatal loss on depressive symptoms, anxiety, quality of intimate partner relationships, and concerns about and investment in their infant over the course of late pregnancy through the first six months after the subsequent birth of a healthy infant by gender of the parent. A three-group, three-wave panel design will be used to collect longitudinal data from expectant mothers and fathers in the third trimester of pregnancy (T1), two months postpartum (T2), and again six months after birth (T3). The sample will consist of 50 couples with a history of prior perinatal loss (early or late fetal or neonatal death), 50 couples pregnant for the first time, and 50 couples who have experienced a previous pregnancy and no loss. Measures include: depressive symptoms (Center for Epidemiologic Studies-Depression Scale), anxiety (Pregnancy Outcome Questionnaire and the Spielberger State-Trait Anxiety Inventory), impact of the previous loss on current emotions (Impact of Event Scale), quality of intimate relationships (Autonomy and Relatedness Inventory), and concerns about and investment in the infant (Maternal/Paternal Attitudes Questionnaire). Knowledge of the trajectory of parents' psychological distress from the third trimester of a subsequent healthy pregnancy through the first six months postpartum will enable identification of parents at risk for continuing psychological distress and for the development of interventions to prevent or decrease adverse outcomes. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Academic Research Enhancement Awards (AREA) (R15)
Project #
1R15NR008492-01
Application #
6666573
Study Section
Special Emphasis Panel (ZRG1-NURS (02))
Program Officer
Bryan, Yvonne E
Project Start
2003-07-01
Project End
2006-06-30
Budget Start
2003-07-01
Budget End
2006-06-30
Support Year
1
Fiscal Year
2003
Total Cost
$146,500
Indirect Cost
Name
University of Louisville
Department
Type
Schools of Nursing
DUNS #
057588857
City
Louisville
State
KY
Country
United States
Zip Code
40292
Hutti, Marianne H; Armstrong, Deborah S; Myers, John (2011) Healthcare utilization in the pregnancy following a perinatal loss. MCN Am J Matern Child Nurs 36:104-11
Armstrong, Deborah S; Hutti, Marianne H; Myers, John (2009) The influence of prior perinatal loss on parents' psychological distress after the birth of a subsequent healthy infant. J Obstet Gynecol Neonatal Nurs 38:654-66