Effect of previous perinatal loss on health behaviors in subsequent pregnancy

Background. Women with a history of perinatal loss report feeling emotionally guarded during subsequent pregnancy and may be at increased risk for pregnancy-related anxiety and greater health care utilization compared to women without previous perinatal loss. However, these behaviors have not been studied extensively in women pregnant after perinatal loss.

Methods. We examined the effect of perinatal loss on health behaviors and health care utilization during a subsequent pregnancy in 2854 pregnant women ages 18-36 expecting their first live-born baby. Self-reported health behaviors and use of health resources during pregnancy were compared for women with a history of two or more perinatal losses and women with one or no perinatal loss.

Results. Women with previous perinatal loss did not differ from women without previous loss for many health behaviors including gestational weight gain, multivitamin use, alcohol consumption, and exercise, but were almost three times as likely to smoke every day (adjusted OR[aOR]=2.94, 95% CI 1.28,6.73). Women with two or more previous perinatal losses received prenatal care one week earlier than women with one or no previous losses (p=0.005), had twice the odds of third trimester emergency department visit (aOR=2.11, 95% CI 1.18,3.75), twice the mean number of ED visits (p=0.023), and twice the number of times admitted (p=0.029).

Conclusions. Women with two or more perinatal losses may be more likely to smoke every day. They were also twice as likely to use ED or hospital services in their third trimester, but did not have an increase in outpatient office visits.