Theme: Supporting Families: Mental Health and Bereavement Care: Abstract 18: Prolonged and Complicated Perinatal Grief Following Stillbirth: A Longitudinal Study

Abstract Background: Perinatal grief is the emotional response of parents to losing a foetus through miscarriage, stillbirth, neonatal loss, or elective termination due to foetal anomalies. Unlike typical grief, perinatal grief is often prolonged and complicated, with intrusive symptoms like persistent longing or preoccupation with the deceased baby, and does not follow predictable stages. Instead, it manifests in varied patterns as individuals adjust to the loss. Adjustment varies among individuals and timeframes. While much research focuses on grief after stillbirth, few studies are available for the long-term effects of prolonged or complicated grief. Aim: To examine the long-term effects of grief after stillbirth, an area that has not been extensively explored. Method: 147 women from a previous study, which validated the Hindi-Perinatal Grief Scale, who experienced stillbirth in 2019, were reached by phone for prolonged grief assessment. To date, 50 women have completed an online questionnaire after informed consent. Participants were screened based on ICD-11 criteria for prolonged grief disorder using the PG-13 scale, Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ) scale for anxiety and depression. Changes in Grief scores (Perinatal grief and prolonged grief), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ) scores over 5 years were analysed using the McNemar test. Results: The mean (SD) age of the participants was 36.17(5.8) years. The prevalence of complicated grief (PGS score >91) six weeks after stillbirth was 34% (50/147), and after 5 years, the prevalence of prolonged grief (PG-13 score >30) was found to be 10% (5/50). Among 50 women who participated in baseline and follow-up assessments, the prevalence of complicated grief (PGS ≥ 91) decreased significantly from 38.0% to 10.0% of prolonged grief (p = 0.003), indicating a meaningful reduction in grief symptoms over time. In contrast, there was no statistically significant change in anxiety (GAD-7 ≥ 10), which remained relatively stable (12.0% at baseline vs. 14.0% at follow-up, p = 1.000), or in depression (PHQ-9 ≥ 10), which showed a slight but nonsignificant increase (8.0% at baseline vs. 16.0% at follow-up, p = 0.344). Conclusion: The study highlights that prolonged grief following stillbirth can persist for a long time. These findings emphasize the need for long-term psychological support and targeted interventions for parents experiencing perinatal grief.