Social support after stillbirth for prevention of maternal depression

Abstract

Objective: To study how social support is associated with ensuing maternal depression following stillbirth.

Design: Data from a population-based national postal questionnaire. Setting. Sweden.

Population: A total of 314 (83%) of all 380 Swedish-speaking women who gave birth to singleton stillborn infants in Sweden during 1991, identified through the Swedish Medical Birth Register.

Methods: Postal questionnaires addressing maternal social support and demographics were completed three years following the stillbirth. The association between support-related factors and later maternal depression was assessed using multivariable regression models.

Main outcome measure: The Center for Epidemiologic Studies Depression Scale.

Results: In adjusted analyses, a father's refusal to talk about a stillborn baby with the mother was associated with an almost five-fold risk of later maternal depressive symptoms [adjusted risk ratio (RR) 4.6, 95% confidence interval (CI) 1.5-14.5]. The mother's belief that she could talk with the infant's father about the child was associated with a reduced risk (adjusted RR 0.5, 95% CI 0.1-0.9).

Conclusions: Unwillingness of the father to discuss a stillborn infant with the mother was related to subsequent maternal depressive symptomatology.