Prevalence of Depression, Anxiety, and Stress in Women with Recurrent Pregnancy Loss and Infertility Compared to Normal Controls in Oman: A Prospective Cross-Sectional Study

Background: Recurrent pregnancy loss (RPL) and infertility are associated with significant psychological morbidity, including stress, anxiety, and depression. While these impacts are well-documented globally, their prevalence and severity in the Omani population remain unexplored. This study investigates the mental health outcomes of Omani women with RPL and infertility compared to fertile controls. Objectives: To assess the prevalence of stress, anxiety, and depression in women with recurrent pregnancy loss (RPL) and infertility, and compare these rates to women with no fertility concerns in an Omani population. Design: A prospective, cross-sectional study. Setting: Sultan Qaboos University Hospital and Royal Hospital in Muscat, Oman. Participants: 111 women with RPL, 131 women with infertility, and 210 antenatal controls with no fertility issues. Interventions: No clinical interventions were administered as this was an observational study. Participants completed validated psychological assessments (DASS-42 and BDI-II). Primary and secondary outcome measures: Primary outcomes were the prevalence rates of stress, anxiety, and depression assessed using DASS-42 and BDI-II. Secondary outcomes included sociodemographic correlates and risk factors Results: The study included 111 women in the RPL group, 131 in the infertility group, and 210 controls. Among RPL patients, 31% reported stress, ranging from mild to extremely severe, while 35.9% of infertility patients reported stress, compared to 17.1% in the control group (p = 0.003). Anxiety was present in 45% of RPL patients, 45.5% of infertility patients, and 28.1% of controls (p = 0.019). Depression, measured by the DASS-42, was most prevalent in the RPL group (34.2%), followed by the infertility group (33.6%), and controls (13.8%) (p < 0.001). Similar results were observed with the BDI-II, with depression rates of 23.4% in the RPL group, 19.1% in the infertility group, and 7.6% in controls (p = 0.02). Conclusions: Women with RPL and infertility in Oman experience significantly higher levels of stress, anxiety, and depression compared to women without fertility concerns. This study did not assess the mental health of male partners, highlighting the need for further research on the psychological impact on both partners. Future studies should focus on developing psychological support interventions and evaluating their impact on patient outcomes.