Interventions to Improve Outcomes After Pregnancy Loss: A Systematic Review.

Area of Science:

• Reproductive Health
• Women's Health
• Perinatal Medicine

Background:

• Stillbirth, second-trimester miscarriage, and recurrent miscarriage significantly impact women's health.
• High-quality evidence for interventions post-discharge is lacking.
• PROSPERO Registration: CRD42022360264.

Purpose of the Study:

• To assess interventions improving general health for women after pregnancy loss.
• To evaluate interventions enhancing subsequent pregnancy outcomes.
• Focus on non-pregnant women post-stillbirth, miscarriage, or recurrent miscarriage.

Main Methods:

• Searched databases from 1995 (updated March 2024).
• Included interventions delivered after discharge for non-pregnant women.
• Screened 18,603 abstracts, assessed 196 full texts, included 15 papers.
• Used narrative synthesis and assessed risk of bias (RoB-2, ROBINS-I, MM Tool).

Main Results:

• Low quality of evidence identified.
• Primary study aim not met due to limited evidence.
• All included studies focused on improving mental health.
• No studies addressed physical health or subsequent pregnancy outcomes.

Conclusions:

• Significant evidence gap exists for post-discharge care after pregnancy loss.
• Urgent need for research on effective interventions.
• Research should target improving women's short- and long-term health and future pregnancy outcomes.