Social support after stillbirth for prevention of maternal depression

Objective. To study how social support is associated with ensuing maternal depression following stillbirth. Design. Data from a population-based national postal questionnaire. Setting. Sweden. Population. A total of 314 (83%) of all 380 Swedish-speaking women who gave birth to singleton stillborn infants in Sweden during 1991, identified through the Swedish Medical Birth Register. Methods. Postal questionnaires addressing maternal social support and demographics were completed three years following the stillbirth. The association between support-related factors and later maternal depression was assessed using multivariable regression models. Main outcome measure. The Center for Epidemiologic Studies Depression Scale. Results. In adjusted analyses, a father's refusal to talk about a stillborn baby with the mother was associated with an almost five-fold risk of later maternal depressive symptoms [adjusted risk ratio (RR) 4.6, 95% confidence interval (CI) 1.514.5]. The mother's belief that she could talk with the infant's father about the child was associated with a reduced risk (adjusted RR 0.5, 95% CI 0.10.9). Conclusions. Unwillingness of the father to discuss a stillborn infant with the mother was related to subsequent maternal depressive symptomatology.