Understanding the Mental Health Impact of Previous Pregnancy Loss Among Currently Pregnant Veterans.

Abstract

Pregnancy loss, including miscarriage and stillbirth, is common and associated with an increased risk for prenatal and postnatal depression, as well as posttraumatic stress disorder (PTSD). Racial disparities have been observed in pregnancy loss, with Black women having higher rates of pregnancy loss and postnatal depression. However, no research to date has examined the mental health and demographic correlates of pregnancy loss within a veteran population. The current study examined associations between pregnancy loss and mental health and demographic correlates among 1,324 pregnant veterans, of which 368 had a history of at least one stillbirth and/or miscarriage. Veterans with a history of pregnancy loss, compared with those without, were more likely to have a diagnosis of anxiety (52.7% vs. 46.4%, p=.04), depression (62.5% vs. 50.8%, p=.0001), or PTSD (46.5% vs. 37.6%, p=.003); were more likely to report receiving mental health care during pregnancy (23.1% vs. 16.8%, p=.01); and were more likely to have experienced military sexual trauma (harassment: 56.5% vs. 49.9%, p=.04; rape: 38.9% vs. 29.3%, p=.0004). Results also indicated that Black veterans were more likely to report a history of pregnancy loss (32.1% vs. 25.3%, p=.01). Further, Black veterans were more likely to experience clinically meaningful prenatal depression symptoms (adjusted odds ratio: 1.90; 95% confidence interval: 1.42-2.54) after accounting for past loss and age in logistic regression models. Taken together, findings from the present investigation corroborate previous research highlighting the deleterious impact of pregnancy loss and extend prior work by examining these associations among a diverse sample of pregnant veterans.