Anxiety as a psycho-emotional response in early reproductive loss

Abstract

Early reproductive loss (ERL) is one of the most frequent and complex issues in reproductive health, simultaneously affecting the physical, emotional, and relational well-being of women and couples. This traumatic event triggers psychological stress through the activation of the hypothalamic-pituitary-adrenal axis and disruption of the neuroendocrine balance, contributing to the onset of anxiety and depressive disorders. Factors such as young age, low educational level, lack of family support, and social stigmatization can amplify the emotional impact, leading to feelings of guilt, fear, and helplessness. This research was conducted as an observational, descriptive, and prospective study using a mixed-methods approach (quantitative and qualitative). It included 38 patients admitted to a tertiary perinatal center, diagnosed with ERL (≤12 weeks of gestation (w.g.)). The Generalized Anxiety Disorder Scale (GAD-7) and semi-structured interviews were used to explore the emotional, cognitive, and relational experiences. Data were processed using IBM SPSS Statistics 21 and Microsoft Excel, in compliance with medical ethics and confidentiality principles. The majority of participants (47.4%) were in the 26-35 age group, and 84.2% were married. ERL most frequently occurred between 7 and 10 weeks of gestation (65.8%). Elevated anxiety levels were identified in 74% of participants, manifested by difficulties in relaxation, persistent worries, and increased irritability. Fear of recurrence of loss was reported by 50% of respondents, and 84% expressed concerns about the consequences on their future reproductive health. The qualitative analysis revealed highlighted feelings of guilt, isolation, and shame, along with a dissonance between outward functioning and inner suffering. ERL represents not only a medical issue but also a profound emotional and identity crisis for patients. The assessment of anxiety using validated tools such as the GAD-7, allows for the early identification of psycho-emotional disturbances and the direction of personalized interventions. Integrating perinatal psychological counseling into the care of patients experiencing ERL and promoting a holistic approach are strongly recommended.