Depression, Anxiety, And Stress Among Women with Recurrent Miscarriage: The Role of Socio-Demographic and Economic Factors

Abstract

Recurrent miscarriage, defined as two or more pregnancy losses before 24 weeks of gestation, can have a considerable psychological impact, but less is known about the sociodemographic characteristics associated with psychological distress among affected women in Nigeria. This cross-sectional survey examined levels of depression, anxiety and stress, and their association with sociodemographic and socioeconomic characteristics, among 200 women with recurrent miscarriage recruited via purposive sampling from five healthcare facilities and online maternal health platforms in Lagos State, Nigeria. Depression, anxiety and stress were measured using the Depression Anxiety Stress Scales–21 (DASS-21). Associations with age, marital status, highest level of education, employment status and household income were examined using Pearson's chi-square test, with Fisher's exact test applied where more than 20% of cells had expected counts below 5, and effect sizes reported using Cramér's V. Distress was observed across all three dimensions, although anxiety showed the highest severity: 40.0% of participants scored in the extremely severe range, compared with 13.0% for depression and 7.0% for stress. Age was significantly associated with anxiety, marital status with depression, and highest level of education with both depression and stress (all p < .05); employment status and income showed no significant associations. Given the non-probability sampling approach, these findings should be interpreted as describing the study sample rather than the wider population. Targeted psychological support, particularly addressing anxiety among older, divorced and less educated women, may be warranted within Nigerian reproductive healthcare settings.