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Maternal affective or substance disorders are risk factors for subsequent pregnancy loss

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Katherine J Gold

Correspondence to: Katherine J Gold, Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine and Family Medicine, University of Michigan Health System, Ann Arbor, MI 48109–0604, USA;



Is pre-existing maternal mental illness associated with pregnancy loss?


1960 women enrolled in the National Comorbidity Survey, 963 of whom (49.1%) had a DSM-III-R psychiatric diagnosis. Exclusions: women with conduct disorder, antisocial personality disorder, and non-affective psychosis; and women who were currently pregnant or had only terminations and no previous live births or pregnancy losses.


General population, USA; data first collected in the 1990s.

Risk factors:

DSM-III-R psychiatric diagnosis of anxiety (general anxiety disorder, panic disorder, simple phobia, social phobia, agoraphobia, post-traumatic stress disorder), affective (depression, dysthymia or mania), or substance disorders (drug or alcohol dependence or abuse; not including tobacco) whose age at onset indicated that they preceded pregnancy. Other risk factors were assessed and adjusted for by multivariable logistic regression analyses.


Self-reported pregnancy loss …

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  • Source of funding: National Institute of Mental Health, the National Institute of Drug Abuse, and the W T Grant Foundation provided funding for the NCS; the Robert Wood Johnson Foundation Clinical Scholars Program.


  • Competing interests: None.