A Study On Psychological Status And Its Influence Factors Of Patients With Recurrent Spontaneous Abortion

Background & Objective: The aim of this study is to investigate the psychological status in patients with recurrent spontaneous abortion(RSA)and analyze the possible influence factors,in order to to provide theoretical support for further psychological intervention.Methods: Women with RSA,only one spontaneous abortion(SA)and no history of SA were invited to complete a questionnaire that assessed basic information,Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS).Basic information included age,body mass index(BMI),education level,household income,husband's age and education level,marriage situation,childbearing history,pregnancy status and therapy during pregnancy(including lymphocyte immunization,aspirin,cortisol and low-molecular-weight heparin).All data were analyzed by T-test,chi-square test,analysis of variance(ANOVA)and Spearman's correlation.Results: Of all 1064 cases included in this study(effective questionnaires collection rate is 96.73%),725 were RSA cases(579 non-pregnant and 146 pregnant),217 cases with one SA(144 non-pregnant and 73 pregnant)and 122 in control group with no history of SA(84 non-pregnant and 38 pregnant).The average SDS score of RSA group is 37.40±9.94,and 8.29% cases(48/579)reached cut-off value,including 6.22% mild depressive(36/579),1.55% moderate depressive(9/579),and 0.52% severe depressive(3/579).The average SAS score is 34.46±9.13,and 6.56% cases(38/579)reached cut-off value,including 4.32% mild anxious(25/579),1.73% moderate anxious(10/579),and 0.52% severe anxious(3/579).The average SDS score of one SA group is 36.65±8.60 and the average SAS score is 33.38±8.14.For control group,the average score is 33.36±7.86 in SDS and 30.79±6.51 in SAS.Both RSA patients and patients with one SA in non-pregnant cases show significantly higher scores than control groups in SDS and SAS.Non-pregnant RSA Patients with lower education level,lower household income and 3~5 years of marriage have significantly higher levels of depression and anxiety.Patients with multiple miscarriages(? 4 times),history of induced abortion and no live birth score significantly higher in SDS.For pregnant women,RSA group is significantly more depressive than control group(38.08±10.02 VS 34.18±7.98).Meanwhile,patients with same numbers of SA show no significant difference in both SDS and SAS scores whether pregnant or not.Also we found that different gestational age(before and after 13 weeks),using in vitro fertilization-embryo transplantation(IVF-ET)or natural conception,using medications and therapy during pregnancy such as lymphocyte immunization,aspirin,cortisol and low-molecular-weight heparin or not,show no difference in pregnant women with history of pregnancy loss.Conclusion: whether recurrent or not,SA patients are much easier to become depressive and anxious,which may be associated with low education level,low household income,3~5 years of marriage,history of induced abortion,multiple miscarriages(?4 times)and no previous live birth.Extra care and support should be given to those patients from doctors,family and society.Psychological intervention and medications are suggested when necessary.