Grief reactions the first year after termination of pregnancy due to fetal anomaly

Termination of pregnancy due to fetal anomaly (TOPFA) can be emotionally complex, yet knowledge of parents' grief remains limited. This study examined grief reactions among 677 TOPFA bereaved parents in the Danish Life After Loss cohort at 1, 7, and 13 months post-loss, stratified by gender. Adaptive grief reactions were assessed using the Inventory of Daily Widowed Life, symptoms of prolonged grief disorder (PGD) with the Prolonged Grief Disorder Checklist, and pregnancy loss-specific reactions with the Perinatal Grief Scale. Parents showed high initial grief, followed by a significant decline in grief scores across the three time-points. Heterogeneity was observed, with a subgroup displaying elevated grief. Women reported higher scores than men; however, among parents in the upper quartile of grief scores, women's scores declined between 7 and 13 months, whereas men's remained stable. Single-Items showed emotional pain, longing, and guilt/self-blame in a considerable proportion of parents at 13 months post-loss.