AUTHOR=Wang Ting-ting , Liu Yi-lin , Hou Yue , Li Jia-po , Qiao Chong 

TITLE=The risk factors of progestational anxiety, depression, and sleep disturbance in women with recurrent pregnancy loss: A cross-sectional study in China

JOURNAL=Frontiers in Psychology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1116331

DOI=10.3389/fpsyg.2023.1116331

ISSN=1664-1078

ABSTRACT=The risk factors of progestational anxiety, depression, and sleep disturbance in women with recurrent pregnancy loss (RPL) remain controversial, additional study is needed to investigate the incidence and risk factors of progestational anxiety, depression, and sleep quality in RPL women. A cross-sectional study was conducted among 861 non-pregnant RPL women in Northeast China from October 2019 to July 2022. We assessed the state of anxiety, depression, and sleep quality before pregnancy using structured questionnaires, including sociodemographic characteristics, State-Trait anxiety scale(STAI), Center for Epidemiological Survey, Depression Scale (CES-D), Pittsburgh Sleep Quality Index (PSQI), and Symptom self-rating Scale (SCL-90). Pearson correlation analysis was used to evaluate the correlation between sleep quality and depression. Multivariate logistic regression analysis was used to find the independent risk factors of depression symptoms. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of the model.  The incidence of state anxiety, trait anxiety, depression, and sleep disturbance in RPL women were 60.3%, 51.7%, 33.9%, and 31.2%, respectively. The mental state of RPL women fluctuates at different stages of diagnosis and treatment. When the cause was identified, anxiety and depression levels were significantly lower than at the first visit. Sleep disturbance is positively correlated with anxiety and depression. Logistic regression showed that the number of abortions ≥4 (Odds ratio (OR)=2.268, 95%CI 1.300-3.956), Low household family income (OR=1.613, 95%CI 1.036-2.513/OR=2.361, 95%CI 1.095-5.092), interval since last abortion＜6 months (OR=2.154, 95%CI 1.246-3.726) and sleep disturbance (OR= 5.523, 95%CI 3.542-8.614) were associated with the occurrence of depressive symptoms. At the same time, anxiety can be used as a predictor of depression, and trait anxiety can better predict depression.  RPL women have a certain degree of anxiety, depression, and sleep disturbance. Education level, interval since the last abortion < 6 months, and sleep disturbance are the independent risk factors for anxiety and depression. A history of pregnancy loss after 14 weeks and no living birth are also closely related to anxiety. Therefore, it is necessary to pay close attention to the psychological state of RPL women and provide appropriate psychosocial support to reduce the occurrence of negative emotions.