open access publication

Article, 2023

'You're never pregnant in the same way again': prior early pregnancy loss influences need for health care and support in subsequent pregnancy

HUMAN REPRODUCTION OPEN, Volume 2023, 3, 10.1093/hropen/hoad032

Contributors

Koert, E. (Corresponding author) [1] Hartwig, Tanja S. [1] Malling, G. M. H. [1] Schmidt, Lone 0000-0002-9518-1734 [1] Nielsen, Henriette 0000-0003-2106-8103 [1]

Affiliations

  1. [1] Copenhagen Univ Hosp, Amager & Hvidovre Hosp, Dept Obstet & Gynecol, Copenhagen, Denmark
  2. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD]

Abstract

Couples reported their distress was lower and overall needs for care were met during this time. They expressed general satisfaction with regular or extended antenatal support although, as in the first 20 weeks, additional acknowledgement and sensitivity regarding their history of PL was desired. Couples said they felt more secure given that they had access to a 24-hour telephone support by midwife/nurse if they had any concerns or questions. LIMITATIONS, REASONS FOR CAUTION Participants were self-selected from an ongoing cohort study of patients presenting at hospital with PL. Single women were not included in the study. This study was limited to data collection in Denmark; however, other countries with public healthcare systems may have similar offerings with regard to their provision of antenatal care, care provided in recurrent pregnancy loss (RPL) clinics and the availability of private scans. WIDER IMPLICATIONS OF THE FINDINGS The findings underscore that an early PL creates an increased need for monitoring and care in a subsequent pregnancy. This study highlights a gap in pregnancy care for those with a history of PL given that their need for monitoring and support is high in the early weeks of a new pregnancy before they have access to antenatal care, and before they have had multiple PLs and can be referred to the RPL unit. STUDY FUNDING/COMPETING INTEREST(S) This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 101028172 for E.K. The Copenhagen Pregnancy Loss Cohort is funded by a grant from the BioInnovation Institute Foundation. H.S.N. has received scientific grants from Freya Biosciences, Ferring Pharmaceuticals, BioInnovation Institute, Ministry of Education, Novo Nordisk Foundation, Augustinus Fonden, Oda og Hans Svenningsens Fond, Demant Fonden, Ole Kirks Fond, and Independent Research Fund Denmark. H.S.N. received personal payment or honoraria for lectures and presentations from Ferring Pharmaceuticals, Merck, Astra Zeneca, Cook Medical, Gedeon Richter, and Ibsa Nordic. All other authors declare no competing interests.

Keywords

early pregnancy loss, longitudinal study, pregnancy, pregnancy care, psychosocial factors

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