Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany.
Eur J Psychotraumatol. 2022 Aug 18;13(2):2108578. doi: 10.1080/20008066.2022.2108578. eCollection 2022.
Women who have had miscarriages or stillbirths are known to have a high risk for enduring grief. However, the course and frequency of enduring grief in this subgroup are not fully understood. Our aims were to assess the intensity of grief and its course in women with miscarriages or stillbirths and to estimate the frequency of severe grief reactions in this population. Additionally, we compared subgroups with miscarriages versus stillbirths and with single versus recurrent pregnancy loss. A systematic literature search of the databases MEDLINE, psycINFO and PSYNDEX was conducted to consider all studies published between 2000 and 31 March 2022 in English or German on the prevalence and intensity of grief in women who had miscarriages or stillbirths. Studies that used validated assessment methods were included in this systematic review. The PRISMA guidelines were followed. Study characteristics and grief data were extracted independently by two investigators from 13 cross-sectional and eight longitudinal studies from 11 countries ( = 2597). All studies used self-reporting instruments. According to 17 of 21 studies (81%), grief is markedly elevated in women after miscarriages or stillbirths. The studies are very heterogeneous regarding the samples, the length of pregnancies and the time of assessment regarding grief after miscarriages. Most studies document intense grief and frequent severe grief reactions - with a decrease over time - in women who have had miscarriages or stillbirths. Clear conclusions regarding corresponding differences between women with miscarriages and stillbirths or single and recurrent pregnancy losses cannot be drawn. Pronounced grief is frequent in women who had miscarriages or stillbirths. More longitudinal studies are needed to examine the course of grief in this group and to identify those women who develop prolonged grief disorder, depression or other mental-health problems.
曾经历流产或死胎的女性已知存在持续悲伤的高风险。然而，该亚组人群中持续悲伤的过程和频率尚未完全了解。我们的目的是评估流产或死胎后女性的悲伤强度及其过程，并估计该人群中严重悲伤反应的频率。此外，我们比较了流产组与死胎组、单次妊娠丢失组与复发性妊娠丢失组。通过系统检索 MEDLINE、psycINFO 和 PSYNDEX 数据库，考虑了 2000 年至 2022 年 3 月 31 日期间以英文或德文发表的所有关于曾经历流产或死胎的女性悲伤的普遍性和强度的研究。纳入了使用验证评估方法的研究。本系统评价遵循 PRISMA 指南。两名研究人员独立从来自 11 个国家的 13 项横断面研究和 8 项纵向研究中提取研究特征和悲伤数据（ = 2597）。所有研究均使用自我报告工具。根据 21 项研究中的 17 项（81%），流产或死胎后女性的悲伤明显升高。关于样本、妊娠时间长短以及流产后评估悲伤的时间，这些研究非常多样。大多数研究记录了曾经历流产或死胎的女性的强烈悲伤和频繁的严重悲伤反应 - 随着时间的推移而减少。对于流产组和死胎组或单次妊娠丢失组和复发性妊娠丢失组之间的相应差异，无法得出明确的结论。曾经历流产或死胎的女性中频繁出现明显悲伤。需要更多的纵向研究来检查该人群中悲伤的过程，并确定那些发展为持续性悲伤障碍、抑郁或其他心理健康问题的女性。
