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Meta-Analysis
. 2012 Mar 14;2012(3):CD008679.
doi: 10.1002/14651858.CD008679.pub2.

Follow-up for improving psychological well being for women after a miscarriage

Fiona A Murphy  1 , Allyson Lipp, Diane L Powles
Affiliations
Meta-Analysis

Follow-up for improving psychological well being for women after a miscarriage

Fiona A Murphy et al. Cochrane Database Syst Rev. .

Abstract

Background: Miscarriage is the premature expulsion of an embryo or fetus from the uterus up to 23 weeks of pregnancy and weighing up to 500 grams. International studies using diagnostic tools have identified that some women suffer from anxiety, depression and grief after miscarriage. Psychological follow-up might detect those women who are at risk of psychological complications following miscarriage. This review is necessary as the evidence is equivocal on the benefits of psychological follow-up after miscarriage.

Objectives: Whether follow-up affects the psychological well being of women following miscarriage.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2011), reference lists of all retrieved papers and contacted professional and lay organisations to obtain any ongoing trials or unpublished data.

Selection criteria: Randomised controlled trials only.

Data collection and analysis: All potential trials for eligibility according to the criteria specified in the protocol by screening the titles and abstracts, retrieving full reports of potentially relevant trials for assessment. All review authors extracted data and checked for accuracy. No studies were published in duplicate. When data were missing and only the abstract was available, we attempted to contact the trial authors. We resolved any disagreement through discussion.

Main results: Six studies involving 1001 women were included. Three trials compared one counselling session with no counselling. There was no significant difference in psychological well being including anxiety, grief, depression avoidance and self-blame. One trial compared three one-hour counselling sessions with no counselling at four and 12 months. Some subscales showed statistical significance in favour of counselling and some in favour of no counselling. The results for two trials were given in narrative form as data were unavailable for meta-analyses. One trial compared multiple interventions. The other trial compared two counselling sessions with no counselling. Neither study favoured counselling.

Authors' conclusions: Evidence is insufficient to demonstrate that psychological support such as counselling is effective post-miscarriage. Further trials should be good quality, adequately-powered using standardised interventions and outcome measures at specific time points. The economic implications and women's satisfaction with psychological follow-up should also be explored in any future study.

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Conflict of interest statement

None known.

Figures

1
1
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 One counselling session versus no counselling (at four months), Outcome 1 Psychological well being.
2.1
2.1. Analysis
Comparison 2 Three one‐hour counselling sessions versus no counselling (at four months), Outcome 1 Psychological well being.
3.1
3.1. Analysis
Comparison 3 Three one‐hour counselling sessions versus no counselling (at 12 months), Outcome 1 Psychological well being.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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    1. Adolfsson A. The effect of structured second visit to midwifes in women with early miscarriages, a randomized study. 10th International Conference of Maternity Care Researchers; 2004 June 13‐16; Lund, Sweden. 2004:22. [CN‐00487510]
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