Factors affecting the grieving process after perinatal loss

Makiko Kishimoto; Arisa Yamaguchi; Marina Niimura; Miki Mizumoto; Tatsuo Hikitsuchi; Kohei Ogawa; Nobuaki Ozawa; Yoshiyuki Tachibana

doi:10.1186/s12905-021-01457-4

Factors affecting the grieving process after perinatal loss

BMC Womens Health. 2021 Aug 26;21(1):313. doi: 10.1186/s12905-021-01457-4.

Authors

Makiko Kishimoto¹, Arisa Yamaguchi², Marina Niimura², Miki Mizumoto³, Tatsuo Hikitsuchi⁴, Kohei Ogawa⁵, Nobuaki Ozawa⁶, Yoshiyuki Tachibana⁴

Affiliations

¹ Division of Early Childhood Mental Health, Department of Psychosocial Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. kishimoto-m@ncchd.go.jp.
² Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
³ Faculty of Communication and Culture, Shoin University, Kanagawa, Japan.
⁴ Division of Early Childhood Mental Health, Department of Psychosocial Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
⁵ Division of Obstetrics, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
⁶ Division of Obstetrics, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.

Abstract

Background: Factors associated with the grief process in response to perinatal loss have been investigated. However, few studies focused on the intrapersonal factors, such as developmental and personality traits. Hence, this study aimed to investigate medical and psychosocial risk factors, including inter- and intrapersonal factors for the development of complicated grief following perinatal loss, while considering emotional support.

Methods: A total of 50 patients who were treated for grief due to perinatal loss at the National Center for Child Health and Development were divided into two groups according to the treatment period (< 6 months: n = 28; ≥ 6 months: n = 22). We compared medical and psychosocial variables between the two groups using the χ² test and t test. All data were further analyzed using a logistic regression model to adjust for confounding effects.

Results: Patients who had traits of developmental/personality disorders (adjusted odds ratio [OR]: 7.21, 95% confidence interval (CI): 1.21-42.9, P = .030), and those treated with psychoactive drugs (adjusted OR: 5.77, 95% CI 1.09-30.5, P = .039) required a longer treatment period (≥ 6 months).

Conclusions: Patients with personality/developmental traits and those with active psychiatric symptoms required a more extended treatment period in response to loss, suggesting the accumulation of negative factors in these patients; thus, more intensive and specialized care is necessary for these patients. Precise analysis of the coping style, attachment style, communication skills, and life history including relationship with the original family of the patients may have implications on the approach toward patients with complicated grief after perinatal loss. Studies with larger sample size are required to increase the reliability of the present findings, and future research should address the effects of the differential attachment and coping styles of patients with developmental/personality traits on the grief process.

Keywords: Attachment style; Complicated grief; Coping style; Developmental trait; Perinatal loss; Personality trait.

MeSH terms

Adaptation, Psychological*
Child
Female
Grief*
Humans
Pregnancy
Reproducibility of Results