Complicated grief following pregnancy loss in women with autoimmune rheumatic diseases: a comparative cross-sectional study.

BACKGROUND

Women with autoimmune rheumatic diseases (ARDs) present a higher rate of obstetric adverse events including perinatal losses (PL). The aim of this study is to determine the frequency of both complicated grief (CG) following PL and resilience in women with ARDs and compare it to a control group.

METHODS

We performed an analytical, comparative, cross-sectional study from November 2022 to July 2024. Women with and without an ARD diagnosis with a history of PL who completed a self-report survey including the Perinatal Grief Scale (PGS) and the Wagnild and Young Resilience Scale (RS) were selected. We analyzed sociodemographic data, clinical characteristics, and scale scores with SPSS Version 25.

RESULTS

Ninety participants were enrolled in this study. Thirty-three women met criteria for CG following PL, 22 (66.7%) belonged to the control group and 11 (33.3%) to the ARD group (p = 0.016). The RS median score was 138.00 (IQR 117–163). A logistic regression revealed that having an ARD is independently associated with not presenting CG (OR = 0.338; p = 0.018, 95% CI = 0.138–0.829), suggesting that women with ARDs are 2.95 times less likely to develop CG.

CONCLUSIONS

Women with ARDs had a lower frequency of CG following PL than the control group. We found no significant difference between groups regarding resilience capacity. The logistic regression suggests that ARDs serve as a protective factor for developing CG following PL. Screening for CG following PL in women with and without ARDs may help optimize maternal and infant health. CLINICAL TRIAL NUMBER: Not applicable.