Factors shaping participation in longitudinal cohorts may introduce bias, but there is a lack of research concerning participation patterns in cohorts of bereaved. Our aim was to study this in a longitudinal cohort of parents with a loss in pregnancy or during the neonatal period. Using data from the Danish national registers we identified all parents who experienced a pregnancy or neonatal loss in 2016-2018 and linked that with data on participants from the Life After the Loss cohort. Analyzing 725 parents, baseline participation was 25.7%, with 72.6% and 59.7% continuing at the seven- and 13-month follow-up. Partners and parents with lower education were underrepresented at baseline and at follow-up. Although not statistically significant, substantial underrepresentation of parents with mental health conditions and of parents who lived alone was observed at baseline. Although initial participation was low, after enrollment, most parents engaged in follow-up, minimizing the risk of attrition bias.

Pregnancy loss is a traumatic experience, and the quality of care can vary significantly across healthcare settings. However, evidence on the impact of different types of care on psychological outcomes is limited. This study examined the relationship between specialized care for parents experiencing pregnancy or neonatal loss and the level of Prolonged Grief Disorder (PGD) and Post-Traumatic Stress Disorder (PTSD) symptoms, as well as the role of midwifery support, one month post-loss. Using longitudinal data from 732 Danish parents who experienced a loss between 2016 and 2021, we found that 22.5% (n = 165) received specialized care. Compared to standard care, specialized care was associated with fewer PGD and PTSD symptoms. Additionally, parents who received specialized care reported significantly higher levels of midwifery support, with variation by type of loss (miscarriage/termination/stillbirth/neonatal death). While this study indicates benefits from specialized care for bereaved parents, further studies should be conducted to consolidate these findings.

In this study, we describe continuing bonds and grief reactions and assess their association in 980 parents bereaved in pregnancy, at or shortly after birth. We found that most parents experienced continuing bonds. However, they differed by type of loss. Parents losing their child due to termination of pregnancy or miscarriage experienced bonds less frequently and had the least intense grief reaction. Parents losing their child postpartum experienced bonds most frequently and had the most intense grief reaction. Continuing bonds were associated with intensified grief in parents losing their child after termination or miscarriage, while this relationship was less obvious after stillbirth or postpartum death.

Distinguishing patterns of grief over time in parents with a loss in pregnancy or during the neonatal period is important for identification of parents with severe grief symptoms, who may need additional support. Our aim was to describe grief in this population and to examine variations by type of loss in a large prospective cohort. We used questionnaire data from the Danish longitudinal cohort, Life After the Loss, which contains information on parents with a loss in pregnancy (from 14 weeks) or during the neonatal period. Parents completed the Prolonged Grief-13 scale at 1, 7, and 13 months after their loss. We applied Latent Growth Mixture Modelling to identify prolonged grief trajectories and used multinomial regression models to assess factors associated with class membership. Three distinct trajectories were identified in 676 parents: resilience (73.1%), recovery (16.9%), and chronic (10%). The distribution varied by type of loss, and the chronic group were overrepresented by parents with stillbirths (16.2%) and neonatal deaths (16.1%) in contrast to parents with spontaneous abortions (8.2%) and termination of pregnancy due to fetal anomalies (6.2%). Furthermore, not having a living child or being a woman was associated with following the chronic trajectory. These results underline that, while most bereaved parents are resilient, 10% experience consistently high levels of grief symptoms during the first year after the loss. Information on type of loss, gender, and whether the parent has living children are meaningful indicators of grief class membership.

This study describes religious/spiritual beliefs, practices, changes, and needs among parents bereaved by pregnancy or neonatal loss, and assess gender differences in religiosity/spirituality, in this population. A cross-sectional study using data from the Danish cohort Life After the Loss was conducted. Data were gathered from a questionnaire survey collected between January 2016 and December 2019. Among 713 respondents, several answered in the affirmative to items related to religious/spiritual beliefs and practices. Some experienced changes in religious/spiritual beliefs and practices, and some wished to talk to someone about these questions. Women reported higher levels of religiosity/spirituality than men.

The death of a baby is often a life-changing and devastating experience for the family.1 The parents are at increased risk of adverse outcomes following a perinatal death: psychological and emotional distress, post-traumatic stress disorder, long term guilt, intense grief for more than two years, and even a higher risk of long-term morbidity and mortality

Objective To describe the prevalence of spondyloarthritis (SpA) and subtypes diagnosed prior to delivery in a nationwide population of pregnant women, and to estimate how SpA was associated with adverse pregnancy-related outcomes. Methods Using the Danish Medical Birth Register, we identified 1,199,610 singleton pregnancies (1997-2016). Information on SpA and related subtypes (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel diseases, and undifferentiated SpA) was derived from the Danish National Patient Registry. Odds ratios were calculated using logistic regression models. The analyses were performed with overall SpA as exposure and stratified by subtype. Results The overall prevalence of SpA diagnosed prior to delivery was 0.31%, increasing from 0.1% in 1997 to 0.6% in 2016. Comparing women without SpA to women with SpA, the adjusted odds ratios were increased for moderately preterm birth (ORadj 1.56 [95% confidence interval (95% CI) 1.33-1.83]), very preterm birth (ORadj 1.47 [95% CI 1.04-2.08]), elective cesarean section (ORadj 1.44 [95% CI 1.26-1.64]), emergency cesarean section (ORadj 1.17 [95% CI 1.04-1.33]), and use of epidural (ORadj 1.11 [95% CI 1.02-1.20]). The odds ratios for small for gestational age birth and preeclampsia were not increased for women with SpA compared to controls. Results were comparable for the subtypes of SpA. Conclusion Pregnancies in women with SpA were more often complicated by adverse pregnancy outcomes than pregnancies in women without SpA. Clinicians should be aware of this when advising women with SpA in their childbearing years. Future research should focus on investigating causal relations and possible interventions aimed at preventing these outcomes.

Objective: To describe the clinical characteristics of women admitted to a specialized unit for bereaved parents and to identify the characteristics of women who stayed more than 2 days. Design: A population-based descriptive study. Setting: A midwifery-led specialized unit for bereaved parents at Aarhus University Hospital, Denmark. Participants: Women with miscarriage (>14 weeks), missed abortion (>14 weeks), termination of pregnancy (>14 weeks), stillbirth, or death of their neonate during the first 48 hours after birth. Methods: We collected information from the electronic health care records for women admitted to the unit from January 2012 through December 2018, including parity, type of loss, gestational age, mode and duration of birth, pain relief, and duration of stay. Results: From January 1, 2012. to December 31, 2018, 579 women were admitted to the unit. Hospitalization varied from 1 day to 1 week. More women with a loss after 22 gestational weeks stayed for more than 2 days. In multivariate analyses, the hazard ratio (HR) of staying longer than 2 days was 1.3 times greater for primiparous women than for multiparous women (HR = 1.3, 95% confidence interval [1.0, 1.7]) and 2.4 times greater for women with near-term loss compared to women with perinatal loss before gestational week 22 (HR = 2.4, 95% confidence interval [1.7, 3.6]). Conclusion: Providing unlimited stay at a specialized unit for perinatal loss resulted in variation in length of stay. Primiparous women and women who lost neonates or fetuses closer to term gestation were more likely to stay in the unit for up to 8 days. This may indicate a need for individual support not available in standard care. JOGNN, 50, 714-723; 2021. https://doi.org/10.1016/j.jogn.2021.06.009

BACKGROUND:Many parents bereaved of a stillborn baby spend time with the child. In this time frame, different acts with the child in focus may occur. Some parents invite others to see the child too. Parents who suffer the loss of a newborn are vulnerable, and understanding acts and practices surrounding the dead newborn is important knowledge for caretakers.AIMS:This article aims to enlighten the amount of time Danish parents spend with their stillborn in hospital settings that encourage this practice. Furthermore, it aims to transcend the mere quantitative numbers through a theoretical approach that frames the analysis and discussion of possible layers of meaning imbedded in time spent with a dead newborn.STUDY DESIGN:Data from a Danish cohort of bereaved parents were collected using web-based questionnaires. These numbers were successively interpreted through an anthropological lens within the perspective of transition and ritualisation. Knowledge from existing empirical literature was also fused.RESULTS FROM THE COHORT:Danish parents spend hours or days with their stillborn child. They feel supported in this by healthcare professionals. Mainly close relatives join the parents while admitted to the hospital to see the stillborn child, followed by other family members and friends.CONCLUSION:Danish parents engage to a very high degree in contact with their dead baby. The analysis points out that 'Time' and 'Others' are needed to create a socially comprehensible status for parents and child when birth brings death. In liminal space during the transition, healthcare professionals act as ritual experts, supporting parents and their relatives to ascribe social status to the dead body of the child through ritualised acts. Instead of only thinking of this period as 'memory-making', we suggest regarding it as a time of ontological clarification as well.