Do depression and stress affect patients’ chances of becoming pregnant after multiple miscarriages?

This study examined the rates of stress and depression among patients who have had multiple miscarriages. The authors found that depression and stress did not impact future chances of becoming pregnant and that a successful pregnancy reduced emotional distress.

Pregnancies that do not reach full term are called miscarriages. There are many reasons that a pregnancy may result in miscarriage. Pregnancies that result in miscarriage can cause significant stress, affecting a patient’s mental health. Some patients experience multiple miscarriages, even after a successful pregnancy. 

Previous studies have shown that patients who have multiple miscarriages are more likely to experience stress and depression. However, it is unclear if stress and depression following multiple miscarriages affect future chances of having a successful pregnancy.

301 patients who experienced 3 or more consecutive miscarriages received two questionnaires. 296 patients were included in the final analysis. The first questionnaire assessed mental health, and the second one assessed stress levels. 61% (185 patients) completed the second questionnaire. Patients were followed for 1 year.

At follow-up, 69% of patients had a successful pregnancy. 31% of patients had 1 or more pregnancy loss. Overall, 70% of patients who had major depression had a successful pregnancy compared to 55% in the rest of the patient population.

Patients who had major depression at the beginning of the study were as likely to have a successful pregnancy as patients who did not. 89% of patients with major depression became pregnant within a year compared to 77% of patients who did not have major depression. Major depression did not significantly affect the chances of a successful pregnancy.

122 patients reported high stress levels. These patients were also as likely to become pregnant within a year compared to those not highly stressed. 80% of patients with high stress scores became pregnant within a year compared to 77% of patients with lower stress scores (134 patients).

At follow-up, patients who had a successful pregnancy within 1 year reported lower scores for stress levels and depression. Among patients with major depression, the average depression score decreased from 13.45 to 11.04. Among patients with high stress, the average stress score dropped from 17.69 to 13.03. 

Patients experiencing multiple miscarriages after a successful birth had a lower average stress score (16.04) than patients who had not yet had a successful pregnancy (17.28).

The authors concluded that major depression and high stress levels did not impact a patient’s chances of becoming pregnant or of having a successful pregnancy. Patients' emotional distress was reduced following a successful birth.

This study collected data using questionnaires given to patients. Also, the duration of depression and stress was not recorded. Larger studies with a longer follow-up time are needed to confirm these results.