Predicting Need for Follow-Up Due to Severe Anxiety and Depression Symptoms After Perinatal Loss

Objective: To evaluate the ability of the Perinatal Grief Intensity Scale (PGIS) when used within 8 weeks of perinatal loss to predict intense anxiety and severe depression symptoms in women 3 months later (Time 2 [T2]). Design: Prospective survey. Setting: Participants were recruited from hospitals in Louisville, KY and via the Internet. Participants: Women (N = 103) who experienced perinatal loss. Methods: Data were collected using the PGIS, Beck Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale. We used logistic regression, odds ratios, and receiver operating characteristic curve analysis. Results: The PGIS had 97.9% sensitivity and 29.6% specificity to predict severe depression symptoms and 95.2% sensitivity and 56.2% specificity to predict intense anxiety at T2. A baseline PGIS score greater than or equal to 3.53 predicted severe depression symptoms (odds ratio = 1.82, 95% confidence interval [CI] [1.46, 2.18], p =.014) and intense anxiety (odds ratio = 1.43, 95% CI [1.07, 1.82], p =.029) at T2. The receiver operating characteristic curves of the PGIS suggest the PGIS performs well at predicting (screening positive) for severe depression symptoms (area under the curve = 0.86, 95% CI [0.79, 0.94], p <.001) and intense anxiety (area under the curve = 0.86, 95% CI [0.78, 0.93], p <.001) after perinatal loss. Conclusion: The PGIS accurately predicted intense anxiety and severe depression symptoms 3 to 5 months after perinatal loss. This instrument may help health care providers identify women who need further mental health evaluation after perinatal loss.