{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:38:52Z","timestamp":1789115932198,"version":"build-2803163510"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Matern Child Health J"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Stillbirth is a traumatic event with potentially lifelong effects on maternal mental health, but there are few clinical guidelines or resources for supporting families. Additionally, the effects of parental autopsy decision-making and knowledge of cause of death effect on maternal mental health is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated associations between autopsy decision, cause of death determination, and maternal mental health in data from the multi-center, five region Stillbirth Collaborative Research Network (2006-2008). Secondarily, we examined psychosocial risk factors associated with adverse MMH outcomes. Maternal mental health was assessed at single time point within 6\u201336 months after stillbirth delivery. Exposures included autopsy decision (none, partial, full) and knowledge of cause of death (known, unknown). Adverse maternal mental health was defined as abnormal scores on one or more validated instruments assessing depression, grief, distress, post-traumatic growth, and change in substance use. Psychosocial risk factors included childhood trauma and perceptions of support or blame. Logistic regression identified associations with maternal mental health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 272 participants (44% response rate), 54% reported one adverse maternal mental health outcome 6\u201336 months postpartum. Autopsy decision and knowledge of cause of death did not impact maternal mental health. Knowledge of cause of death was associated with less feeling of blame (OR 2.02, 95% CI 1.05\u20133.88). Childhood trauma (OR 4.10, 95% CI 1.60\u201310.70) and low income (OR 2.32, 95% CI 1.34\u20134.02) were associated with poorer maternal mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the impact of stillbirth on maternal health, our understanding of factors impacting mental health is limited, and the clinical guidelines for providing psychological care are limited. In the current study, autopsy decision and knowledge of cause of death did not impact mental health outcomes 6-36 months postpartum, while childhood trauma, feeling blamed for the loss, and socioeconomic disadvantage were significantly associated with adverse mental health. This important, early data from the Stillbirth Collaborative Research Network may help inform screening for psychosocial risk factors and updating guidelines for providing trauma-informed support following stillbirth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10995-026-04314-8","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:18:55Z","timestamp":1787149135000},"page":"1191-1204","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Mental Health After Stillbirth: Associations With Autopsy Decisions, Cause of Death Knowledge, and Psychosocial Risk Factors"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9053-8156","authenticated-orcid":false,"given":"Rana","family":"Jawish","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1266-7297","authenticated-orcid":false,"given":"Emily","family":"DiBlasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-7193","authenticated-orcid":false,"given":"Amanda A.","family":"Allshouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-8587","authenticated-orcid":false,"given":"Renee","family":"Martin-Willett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0169-6989","authenticated-orcid":false,"given":"Becky","family":"Kinkead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5148-9219","authenticated-orcid":false,"given":"Matthew","family":"Moench","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8728-0872","authenticated-orcid":false,"given":"Paul J.","family":"Carlson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3010-0662","authenticated-orcid":false,"given":"Marcela C.","family":"Smid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-8871","authenticated-orcid":false,"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-3152","authenticated-orcid":false,"given":"Robert M.","family":"Silver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-0297","authenticated-orcid":false,"given":"Mark H.","family":"Rapaport","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"issue":"3","key":"4314_CR1","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1097\/AOG.0b013e31819e9ee2","volume":"113","author":"ACOG Practice Bulletin 102","year":"2009","unstructured":"ACOG Practice Bulletin 102. 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In the last three years, AJG has been on the board of directors for the American Society of Addiction Medicine (ASAM), the Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA), and the International Society of Addiction Journal Editors (ISAJE), all non-for-profit organizations. AJG does not receive remuneration for these duties. AJG receives remuneration from AMERSA, Inc. for being the Editor in Chief of their peer reviewed journal. Unrelated to this work, University of Utah receives research support from Gilead Sciences Incorporated for M.C.S. study for hepatitis C treatment in pregnancy. The University of Utah receives research support from Koko Medical for MCS and has received funding from Organon on studies related to postpartum hemorrhage control devices. The remaining authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Stillbirth Collaborative Research Network (SCRN), a population-based case-control study that enrolled women in-hospital immediately after delivery, included populations of Rhode Island and selected counties in Massachusetts, Georgia, Texas, and Utah. Investigators selected 59 hospitals to ensure access to at least 90% of all pregnancies to residents ending in live birth or stillbirth. Recruitment and enrollment of 663 cases and 1932 controls occurred between March 2006 and September 2008. Study personnel followed a standardized protocol including maternal interview, medical record abstraction, placental pathology, biospecimen testing, and, for stillbirths, postmortem examination. Also, for each participant, staff requested contact information and requested written consent for further contact. The Stillbirth Collaborative Research Network (SCRN) and the Outcomes after Study Index Stillbirth (OASIS) study were approved by Institutional Review Boards at all participating sites. All procedures were conducted in accordance with the ethical standards of these committees and with the 1964 Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Women were contacted in 2009 (between 6 months and 3 years after their index delivery) if they had provided written informed consent in SCRN. A letter marked confidential and addressed specifically to the participant was sent to her last known address. If the letter requesting permission for a telephone interview was returned or there was no response, site staff tried calling the participant and utilized other contact information to locate the woman. Located women were given an explanation of the follow-up study procedures, after which they provided verbal consent for the telephone interview, conducted in either English or Spanish at their choice. Because women with losses were asked about their grief experience, interviewers were not blind to the index pregnancy outcome. Interviewers were trained to recognize symptoms of immediate distress or indications that the respondent might be contemplating harm to herself or others. In this event, interviewers followed a detailed referral protocol. All women were queried about subsequent pregnancies and complications, and about life-course stresses hypothesized to be associated with an increased stillbirth risk. Psychosocial instruments were selected based on four criteria: (1) validity for telephone interviewing; (2) a validated Spanish translation for the population under study; (3) use for multiple race\/ethnicities; and (4) where relevant, use in other perinatal loss studies.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}}]}}