The influence of prior perinatal loss on parents' psychological distress after the birth of a subsequent healthy infant

Deborah S. Armstrong, Marianne H. Hutti, John Myers

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Objective: To evaluate the long-term influence of a previous perinatal loss on parents' psychological distress during a subsequent childbearing experience. Design and Sample: A cohort design was used to examine 36 couples with a history of prior perinatal loss. Data were collected during the third trimester of pregnancy, 3 months postpartum, and again 8 months after birth. Measures: Outcome measures included posttraumatic stress (The Impact of Event Scale), depressive symptoms (Center for Epidemiologic Studies-Depression Scale), anxiety (Spielberger State-Trait Anxiety Inventory), and parental concerns and attitudes (Maternal/Paternal Attitudes Questionnaire). Results: Levels of depressive symptoms (p<.001), anxiety (p<.001), and posttraumatic stress (p=.046) significantly decreased over time in this population. However, levels of posttraumatic stress remained in the moderate range even at 8 months after birth. Depression was significantly correlated with posttraumatic stress at each time point. In addition, depression was significantly related to posttraumatic stress, anxiety, and concerns parents had about their infant's well-being at T3. Conclusion: While levels of anxiety and depressive symptoms decreased for parents who have experienced a previous perinatal loss, posttraumatic stress levels remained moderately high. It is unclear how this compares to parents without losses. These may be the unique symptoms and concerns these parents have about their new infant. Parents with a history of prior loss should have assessments carefully tailored to their experiences to anticipate continued psychological distress.

Original languageEnglish
Pages (from-to)654-666
Number of pages13
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
Issue number6
StatePublished - 2009

Bibliographical note

Funding Information:
Funded by National Institute of Nursing Research Grant 1-R-15 NR08492-01.


  • Depressive symptoms
  • Parent-infant attachment
  • Perinatal loss
  • Posttraumatic stress

ASJC Scopus subject areas

  • Pediatrics
  • Critical Care
  • Maternity and Midwifery


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