Status
Completed
Title
The Impact of Miscarriage on Mental Health Outcomes
What were the objectives of the study?
The overall aim of this study is to measure the impact of miscarriage on mental health outcomes in women between 16 and 50 years old.
How was the research done?
This observational study investigates the impact of miscarriage on mental health outcomes, self-harm behaviours and eating disorders from the UK NHS perspective using novel primary care data from the QResearch database. The study design and specific structure of the data enable us, for the first time, to estimate medium and long term consequences of miscarriage on a sample of women aged 16-50 years old.
Rigorous empirical methods will be used to compute associations between miscarriage and health outcomes. A distinctive feature of our research design is that we seek a robust picture of the impact of miscarriage on health outcomes, derived by contrasting estimates from different empirical methods and studying a wide range of outcomes.
Chief Investigator
Professor Stavros Petrou
Lead Applicant Organisation Name
Sponsor
University of Oxford
Location of research
University of Oxford
Date on which research approved
05-Oct-2020
Project reference ID
OX90
Generic ethics approval reference
18/EM/0400
Are all data accessed are in anonymised form?
Yes
Brief summary of the dataset to be released (including any sensitive data)
General Practice data - consultations, prescriptions, tests and investigations
Hospital Episode Statistics data - admitted patient care, and outpatient
What were the main findings?
This study examines the impact of miscarriage on self-harm and psychiatric disorders, focusing on variations across different age groups and levels of socio-economic deprivation in the UK. Utilizing the QResearch database, we analyzed a random cohort of 1.2 million women, tracking first-time recorded pregnancies from 01/01/2004 to 31/12/2017 which were categorized using valid medical definitions into miscarriage and continued pregnancies. Women with pre-existing psychiatric conditions or diagnosed self-harm were excluded. Our empirical strategy employed logistic regression. Results indicate substantial discrepancies by socio-economic and sociodemographic factors across all outcomes considered: self-harm, depression, anxiety, post-traumatic stress disorders, psychosis and psychotropic drug prescriptions. The regression results by age groups indicate that women aged under 30, particularly those in the 20-30 age group, showed a significant association between miscarriage and increased anxiety and depression, especially in the initial months following miscarriage. The study demonstrates the need for targeted mental health interventions, particularly in high-deprivation areas and for younger women, underscoring the importance of socio-economic context and age in shaping mental health outcomes post-miscarriage. The findings highlight the complexity of the impacts of miscarriage on psychiatric outcomes, calling for tailored public health strategies in the UK and further research into the underlying socioeconomic and sociodemographic predictors of adverse outcomes following miscarriage.
Implications and Impact
This research will provide much needed evidence for NHS, NICE, Health and Well-being Board commissioners and primary health care practitioners about the best ways to deliver health care to women or couples who experience pregnancy loss.
Funding Source
NIHR School for Primary Care Research, and, Tommy’s, the Baby Charity
Public Benefit Statement
Research Team
Professor Stavros Petrou, The University of Oxford
Prof Julia Hippisley-Cox, The University of Oxford
Dr Catia Nicodemo, The University of Oxford
Dr Shahd Daher, The University of Oxford
Dr Corneliu Bolbocean, The University of Oxford
Professor Siobhan Quenby, University of Warwick
Professor Arri Coomarasamy, University of Birmingham
Access Type
Trusted Research Environment (TRE)