Women's psychological experiences of preterm labour and birth which results in an intrapartum stillbirth or a neonatal death: An empty systematic review

Semra Worrall¹Elana Payne^1,2Rebecca Fellows^2,3Olivia Pike¹Naomi H. Carlisle²Jenny Carter²Anja Wittkowski⁴Karen Burgess^2,5Claire Storey²Laura A Magee²Peter von Dadelszen²Paul Christisnsen¹Victoria Fallon¹Asma Khalil^6,7Sergio A. Silverio^1,2*

• ¹University of Liverpool, Liverpool, North West England, United Kingdom
• ²King's College London, London, England, United Kingdom
• ³Bangor University, Bangor, Wales, United Kingdom
• ⁴The University of Manchester, Manchester, England, United Kingdom
• ⁵PETALS: The Baby Loss Counselling Charity, Cambridge, United Kingdom
• ⁶Liverpool Womens NHS Foundation Trust, Liverpool, United Kingdom
• ⁷St George’s University Hospitals NHS Foundation Trust, London, England, United Kingdom

Introduction: Nearly three quarters of stillbirths and neonatal deaths occur in infants born prematurely. The mothers of these children may be at increased risk of developing mental health difficulties as a result of their premature labour and/or subsequent loss.Methods: This systematic review was conducted to understand the psychological experiences of mothers who gave birth prematurely to a baby who subsequently dies as a result of an intrapartum stillbirth or a neonatal death. Ten databases were searched. Any studies which included women who had suffered a perinatal bereavement as a result of preterm labour and birth, in any country, and in any language were eligible to be included. Studies focusing on antepartum stillbirth or in utero death were excluded due to not having the element of preterm labour and/or birth within the studies. Risk of bias was to be assessed using the Critical Appraisal Skills Programme.Results: Following the screening of citations, no studies were eligible for inclusion in the review. The majority of studies were excluded due to a lack of distinction in terms of intrapartum or antepartum stillbirth, or grouping of types of perinatal loss. Had the studies which were excluded three most common reasons for exclusion been included, 19 studies would have been eligible for inclusion in the review, and we present a brief summary of these findings.Discussion: These review findings highlight the need for more research into the psychological experiences of mothers of preterm infants whose baby subsequently dies, whereby future studies should consider routine reporting of gestational age. To address the identified gaps, future research should consider alternative methods or broader inclusion criteria to capture relevant data. Emphasising the importance of reporting gestational age and distinguishing between types of perinatal loss will enhance the specificity of research findings.