For a study, researchers sought to investigate the link between race and depressive symptoms among patients in a clinical study for early pregnancy loss. The researchers compared therapies for medical management of early pregnancy loss in a planned secondary analysis of a randomized trial. They expected that as compared to non-Black individuals, Black participants would have a greater risk of significant depression (as judged by the CES-D [Center for Epidemiological Studies-Depression] scale) 30 days following early pregnancy loss therapy. They evaluated the data as a cohort, with race as the major exposure and high adverse childhood experience scores as the second exposure (measured with the Adverse Childhood Experience scale). The primary outcome was the risk of significant depression (CES-D score of 21 or higher) 30 days following early pregnancy loss treatment.
From May 2014 to April 2017, 300 patients diagnosed with a nonviable intrauterine pregnancy at 5 to 12 weeks of gestation were randomized as part of the initial experiment. There were 120 [44%] Black respondents and 155 [56%] non-Black respondents among the 275 people polled for this study. Following early pregnancy loss therapy, 65 [24%] of participants were at risk for serious depression. After early pregnancy loss therapy, black individuals had a higher risk of serious depression (57%) than non-black participants (43%) (odds ratio [OR] 2.02; 95% CI 1.15–3.55). Following accounting for baseline depression risk, adverse childhood experience score, and parity, Black individuals had a greater risk of severe depression 30 days after pregnancy loss therapy than non-Black participants (OR 2.02; 95% CI: 1.15–3.55; adjusted OR 2.48; 95% CI: 1.28–4.81).
In general, one-quarter of women who had an early pregnancy loss had a higher chance of developing serious depression 30 days following therapy. When compared to non-Black women, the risk was around twice as high for Black women. Appropriate mental health resources are required for women receiving early pregnancy loss treatment.
