AbstractBackground and Objective: Recurrent pregnancy loss (RPL), defined as two or
more consecutive miscarriages, is a distressing condition affecting approximately
1-2% of women of reproductive age. It not only has profound physiological
implications but also leads to significant psychological distress. Depression
and anxiety are among the most common psychiatric conditions observed in this
population. The objective of this systematic review was to evaluate the
prevalence and severity of depression and anxiety in women with RPL and to
identify potential risk factors and patterns associated with these
psychological outcomes.
Material and Methods: This systematic review was conducted according to
PRISMA guidelines. A comprehensive search was performed using PubMed, Scopus,
Web of Science, and PsycINFO for studies published between January 2000 and
December 2024. Keywords included "recurrent pregnancy loss",
"recurrent miscarriage", "depression", "anxiety",
and "mental health". Inclusion criteria were observational studies
assessing depression and/or anxiety in women with RPL using standardized
diagnostic tools. Studies not in English, case reports, and reviews were
excluded. This study was conducted at Department of Gynaecology, Mayo Institute
of Medical Sciences, Lucknow-Ayodhya Road, Gadia, Uttar Pradesh, India from
August 2015 to July 2016. Data on prevalence rates, assessment tools, and
psychological outcomes were extracted and analyzed qualitatively.
Results: A total of 23 studies involving 7,420 women were
included in the review. The prevalence of depression among women with RPL
ranged from 30% to 60%, while anxiety prevalence ranged from 35% to 70%.
Several studies showed that the risk of psychological distress increased with
the number of pregnancy losses. Tools commonly used included the Beck
Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), and
State-Trait Anxiety Inventory (STAI). Compared to control groups (women without
RPL), significantly higher levels of depression and anxiety were consistently
reported in women with RPL. Psychological symptoms often persisted even after
subsequent successful pregnancies.
Conclusion: Women with recurrent pregnancy loss are at a
markedly increased risk of developing depression and anxiety. This systematic
review highlights the urgent need for routine psychological screening and
integrated mental health support as part of the management of RPL. Tailored
counseling, early intervention, and longitudinal follow-up are essential to
improve the overall well-being and reproductive outcomes of affected women.
