Brier Norman
Department of Psychiatry and Pediatrics, Albert Einstein College of Medicine of Yeshiva University, Children's Evaluation and Rehabilitation Center, Bronx, New York 10461, USA.
J Womens Health (Larchmt). 2008 Apr;17(3):451-64. doi: 10.1089/jwh.2007.0505.
The literature exploring the relationship between miscarriage and grief is sparse. This paper summarizes the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators.
An electronic search of the Medline and Psych Info databases was conducted. Studies were selected for inclusion if they related to early miscarriage, used a standardized measure to assess perinatal grief, and specified the assessment intervals employed. Qualitative studies were included when helpful to develop hypotheses.
Descriptions of grief following miscarriage are highly variable but tend to match descriptions of grief used to characterize other types of significant losses. A sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief unclear. Suggestively, grief, when present, seems to be similar in intensity to grief after other types of major losses and is significantly less intense by about 6 months. Few conclusions can be drawn in regard to potential moderators of grief following a miscarriage.
Although additional research is clearly needed, guidelines for coping with grief following miscarriage can be based on the data available on coping with other significant types of losses. Given the range of potential meanings for this primarily prospective and symbolic loss, practitioners need to encourage patients to articulate the specific nature of their loss and assist in helping them concretize the experience.
探讨流产与悲伤之间关系的文献较为匮乏。本文总结了关于早期流产后悲伤情绪的文献，以阐明此时悲伤情绪的性质、发生率、强度和持续时间，并确定潜在的调节因素。
对Medline和Psych Info数据库进行了电子检索。如果研究与早期流产相关，使用标准化量表评估围产期悲伤情绪，并明确所采用的评估间隔，则将其纳入研究。当定性研究有助于提出假设时也予以纳入。
流产后悲伤情绪的描述差异很大，但往往与用于描述其他类型重大损失的悲伤情绪描述相符。相当大比例的女性似乎会经历悲伤反应，悲伤情绪的实际发生率尚不清楚。提示性地，悲伤情绪一旦出现，其强度似乎与其他类型重大损失后的悲伤情绪相似，且在约6个月时强度会显著降低。关于流产后悲伤情绪的潜在调节因素，几乎无法得出结论。
尽管显然需要更多研究，但流产后悲伤情绪的应对指南可基于应对其他重大类型损失的现有数据制定。鉴于这种主要具有前瞻性和象征性的损失可能具有多种潜在含义，从业者需要鼓励患者阐明其损失的具体性质，并协助他们将这种经历具体化。
