Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life.

This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models.

Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group.

Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.

大约 20% 的妊娠发生产前流产，这是焦虑和情感障碍的一个公认的危险因素。在当前的研究中，我们使用基于生态瞬时评估（EMA）的妊娠特异性痛苦和日常生活情绪测量方法，研究了产前流产史是否与随后妊娠的母亲心理状态相关。

这项研究是在155名健康孕妇队列中进行的，其中 40名有产前流产史。在怀孕早期和晚期使用 EMA 方案来收集母亲压力和情绪的重复测量值，在连续 4 天的时间内平均每天收集 8 次。使用线性混合模型估计产前损失史与心理状态之间的关联。

与之前没有经历过产前流产的女性相比，有产前流产史的女性在怀孕早期和晚期报告的妊娠特异性痛苦程度更高，而且也更加紧张和疲劳。此外，在对照组中，从怀孕早期到怀孕晚期，妊娠特有的痛苦减少，情绪改善，而怀孕期间的这些变化在产前损失组的女性中并不明显。

我们的研究结果表明，前一次怀孕的产前流产与随后的怀孕有关，在怀孕期间的日常生活中压力显着升高，情绪水平受损。这些发现对于设计基于 EMA 的流动个性化干预措施以减轻这一高危人群怀孕期间的压力具有重要意义。