Archives of Gynecology and Obstetrics

, Volume 300, Issue 4, pp 1061–1066 | Cite as

Prevalence of depression and anxiety in women with recurrent pregnancy loss and the associated risk factors

  • Liying He
  • Tongfei Wang
  • Haijing Xu
  • Chao Chen
  • Zhilan Liu
  • Xiaomin Kang
  • Aimin ZhaoEmail author
Gynecologic Endocrinology and Reproductive Medicine



To investigate the prevalence and explore potential risk factors of depression and anxiety in patients with recurrent pregnancy loss (RPL).


1138 non-pregnant women aged 20–40 years old who attempted to conceive were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).


782 RPL women, 218 women with one pregnancy loss and 138 women with no history of pregnancy loss were included in this study. We found that both RPL patients and women with one pregnancy loss had significantly higher SDS and SAS scores than the control group (P = 0.006, 0.003). Furthermore, in RPL patients, those with lower education level (lower than university), lower household income (< 10,000 yuan) and history of induced abortion had significantly higher levels of depression and anxiety. Women with multiple pregnancy losses ( ≥ 3) and no live birth had significantly higher SDS scores. Women who had been married for 3 years or more had a significantly higher SAS score. Logistic regression revealed that lower education level (lower than university) was an independent risk factor for depression (adjusted OR = 1.75, 95% CI 1.10–2.77, P = 0.018) and anxiety (adjusted OR = 1.80, 95% CI 1.04–3.13, P = 0.037), and women with three or more pregnancy losses had increased odds of depression than those with two pregnancy losses (adjusted OR = 1.82, 95% CI 1.15–2.88, P = 0.012).


RPL patients are more likely to develop depression and anxiety than women with no history of pregnancy loss. Lower education level and multiple pregnancy losses (≥ 3) appear to be two independent risk factors of depression and anxiety in women with RPL. Women with one pregnancy loss also show a significant higher level for depression and anxiety. Appropriate psychological intervention can be considered for such patients.


Recurrent pregnancy loss Depression Anxiety Risk factors 



This work was supported by the National Science Foundation of China (Grant No. 91442113, 81270715).

Author contributions

AZ conceptualization: lead. Funding acquisition: lead. Project administration: lead. Resources: lead. Supervision: lead. Writing—review and editing: lead. LH conceptualization: lead. Data curation: lead. Formal analysis: lead. Investigation: lead. Methodology: lead. Software: lead. Writing—original draft: Lead. Writing—review and editing: Lead. TW Data curation: equal. Investigation: equal. HX data curation: supporting. Investigation: supporting. CC data curation: supporting. Investigation: supporting. ZL data curation: supporting. Investigation: supporting. XK: data curation: supporting. Investigation: supporting.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest.

Ethical approval

This study was approved by the Ethics Review Board of Renji Hospital, School of Medicine, Shanghai Jiaotong University (Ethical vote No. [2014] N034 on 11 Nov 2014).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Gynecology and Obstetrics, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
  2. 2.Reproductive Medicine Center, Zhongshan HospitalFudan UniversityShanghaiChina

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