(PS6-A4) Understanding the Impact of Previous Pregnancy Loss Among Currently Pregnant Veterans

Pregnancy loss, including miscarriage and stillbirth, is common in the United States and associated with a variety of negative mental health ramifications for women and parents. For example, pregnancy loss is associated with an increased risk for prenatal and postnatal depression, as well as posttraumatic stress disorder (PTSD). Racial disparities have been observed in pregnancy loss. Specifically, regardless of education or socioeconomic status, Black women, compared to non-Black women, have higher rates of pregnancy loss and postnatal depression. Despite these findings, no research to date has examined the mental health and demographic correlates of pregnancy loss within a Veteran population. The current study examined these associations among 368 currently pregnant Veterans who endorsed a history of at least one stillbirth and/or miscarriage. Pregnant Veterans participated in two telephone surveys, one during pregnancy and another within 12 weeks postpartum. These surveys collected data on demographics, military experience, medical history, pregnancy characteristics, and mental health symptoms. Results indicated that Veterans with a history of miscarriage and/or stillbirth, compared to those without, were more likely to have a self-reported diagnosis of anxiety, depression, or PTSD and were more likely to have a history of mental health treatment and military sexual trauma (all p< 0.05). Findings also indicated that Veterans with a history of loss, compared to those without, were more likely to self-report as Black (p=0.01). Further, Black race was significantly associated with clinically meaningful prenatal depression symptoms after accounting for past loss and age (aOR: 1.90; 95% CI: 1.42 - 2.54). Taken together, findings from the present investigation corroborate previous research highlighting the deleterious impact of pregnancy loss and extend prior work by examining these associations among a diverse sample of pregnant Veterans. Researchers and clinicians alike should continue to assess and treat pregnancy loss among Veterans given its prevalence and impact, particularly among Black women.