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Human Reproduction, Vol. 17, No. 10, 2580-2584, October 2002
© 2002 European Society of Human Reproduction and Embryology

Depression as a potential causal factor in subsequent miscarriage in recurrent spontaneous aborters

Mayumi Sugiura-Ogasawara1,5, Toshiaki A. Furukawa2, Yumi Nakano2, Shiro Hori2, Koji Aoki3 and Toshinori Kitamura4

1 Department of Obstetrics and Gynecology, Nagoya City University Medical School, Nagoya, 2 Department of Psychiatry, Nagoya City University Medical School, 3 Department of Obstetrics and Gynecology II, Josai Municipal Hospital of Nagoya and 4 National Institute of Mental Health, Department of Psychiatry, Kumamoto University School of Medicine, Kumamoto, Japan

BACKGROUND: Unexplained miscarriage is speculated to be due to a Th1/Th2 cytokine imbalance at the feto–maternal interface and immunological functions are known to be under the influence of various psychological factors. Indeed, the psycho–neuro–immuno–endocrine network has been proposed to contribute to miscarriage. To assess whether psychological disorders might induce spontaneous abortion we carried out a prospective study to determine if any psychological parameter influenced risk in those patients with a history of recurrent miscarriages. METHODS: A prospective study was carried out on 61 patients with a history of two consecutive first-trimester miscarriages. A battery of self-report questionnaires including Symptom Checklist-90 Revised and the NEO Five Factor Index and semi-structured interviews were conducted before a subsequent pregnancy. We investigated whether or not these parameters predicted subsequent miscarriages. RESULTS: Ten (22.2%) of the 45 patients who conceived miscarried again. Baseline depressive symptoms influenced subsequent miscarriage (P = 0.004). This statistically significant effect remained when we corrected with Bonfferoni adjustment (P = 0.036). CONCLUSIONS: A high depression scale is associated with a high miscarriage rate in those patients suffering recurrent miscarriage.

Key words: depression/neuroticism/personality/recurrent miscarriage

5 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Nagoya City University Medical School, Mizuho-ku, Nagoya, 4678601, Japan. E-mail: og.mym{at}med.nagoya-cu.ac.jp


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