Post-miscarriage endocrine profiles and psychological distress in women with recurrent pregnancy loss: a case–control study

Post-miscarriage endocrine profiles and psychological distress in women with recurrent pregnancy loss: a case–control study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Post-miscarriage endocrine profiles and psychological distress in women with recurrent pregnancy loss: a case–control study Sertaç Ayçiçek¹ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9116244/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Purpose : Recurrent pregnancy loss (RPL) is associated with significant psychological stress, which may influence neuroendocrine regulation. This study aimed to evaluate endocrine parameters and psychological distress in women with RPL during the early post-miscarriage period compared with fertile controls. Methods : In this case–control study, 52 women with a history of recurrent pregnancy loss and 55 age-and body mass index–matched fertile controls were included. Blood samples were collected between 08:00 and 09:00 AM within 1–2 weeks following miscarriage. Serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), and prolactin were measured using electrochemiluminescence immunoassay. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Group comparisons, correlation analyses, and multivariate logistic regression were performed. Results : Women with RPL demonstrated significantly higher serum cortisol levels and higher HADS anxiety and depression scores compared with controls (all p<0.05). DHEA-S, TSH, fT4, and prolactin levels were significantly lower in the RPL group (all p<0.05). Most hormonal values remained within laboratory reference ranges in both groups. In multivariate analysis, psychological distress remained independently associated with RPL status (OR 3.907, 95% CI 1.610–9.478, p=0.003), whereas hormonal parameters did not retain independent significance. Conclusion : Women with recurrent pregnancy loss exhibited increased psychological distress accompanied by relative alterations in post-miscarriage endocrine profiles. These findings reflect associations observed in the early post-loss period rather than causal relationships. The results highlight the importance of considering psychological well-being in the clinical management of RPL. Health sciences/Biomarkers Health sciences/Diseases Health sciences/Endocrinology Health sciences/Medical research Biological sciences/Psychology Social science/Psychology Cortisol DHEA-S Miscarriage Psychological distress Recurrent pregnancy loss Thyroid hormones Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 19 Mar, 2026 Submission checks completed at journal 18 Mar, 2026 First submitted to journal 18 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9116244","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":608472959,"identity":"f72bdb61-3e09-446e-8f8f-729479c5bef7","order_by":0,"name":"Sertaç Ayçiçek¹","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYDCCA8icD0DMxk5YC2MDmMHGwMA4A0Qzk6KFmQfEIKSF73jz8wcf99TJmc9vfvjZ5tc2eT5mBsYPH3Nwa5E8c8ywccazw8Yyx9iMpXP7bhu2MTMwS87chluLwY0cxmaeAwcSZ7AxmDHn9txmBGphY+YlrKWufgYb+zdmy57b9sRqYU6QYOMxY2b4cTuRoBaQX2bOOHDYcAZbTrFkb8Pt5DZmxma8fgGG2IMPHw7UyUswH9/44cef27bz25sPfviIRwsqYGwDkw3EqgeBP6QoHgWjYBSMgpECAGlNUK0LLmvnAAAAAElFTkSuQmCC","orcid":"","institution":"Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi","correspondingAuthor":true,"prefix":"","firstName":"Sertaç","middleName":"","lastName":"Ayçiçek¹","suffix":""}],"badges":[],"createdAt":"2026-03-13 15:24:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9116244/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9116244/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104937103,"identity":"4e2545f4-5ed4-41d9-a57c-293b0b7d2953","added_by":"auto","created_at":"2026-03-19 01:33:26","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":463011,"visible":true,"origin":"","legend":"","description":"","filename":"ScientificReportsCleanVersion1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9116244/v1_covered_b907e6f5-1e2c-43ee-8089-019b60ebbb10.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePost-miscarriage endocrine profiles and psychological distress in women with recurrent pregnancy loss: a case–control study \u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cortisol, DHEA-S, Miscarriage, Psychological distress, Recurrent pregnancy loss, Thyroid hormones","lastPublishedDoi":"10.21203/rs.3.rs-9116244/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9116244/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose \u003c/strong\u003e: Recurrent pregnancy loss (RPL) is associated with significant psychological stress, which may influence neuroendocrine regulation. This study aimed to evaluate endocrine parameters and psychological distress in women with RPL during the early post-miscarriage period compared with fertile controls.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003e: In this case–control study, 52 women with a history of recurrent pregnancy loss and 55 age-and body mass index–matched fertile controls were included. Blood samples were collected between 08:00 and 09:00 AM within 1–2 weeks following miscarriage. Serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), and prolactin were measured using electrochemiluminescence immunoassay. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Group comparisons, correlation analyses, and multivariate logistic regression were performed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003e: Women with RPL demonstrated significantly higher serum cortisol levels and higher HADS anxiety and depression scores compared with controls (all p\u0026lt;0.05). DHEA-S, TSH, fT4, and prolactin levels were significantly lower in the RPL group (all p\u0026lt;0.05). Most hormonal values remained within laboratory reference ranges in both groups. In multivariate analysis, psychological distress remained independently associated with RPL status (OR 3.907, 95% CI 1.610–9.478, p=0.003), whereas hormonal parameters did not retain independent significance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003e: Women with recurrent pregnancy loss exhibited increased psychological distress accompanied by relative alterations in post-miscarriage endocrine profiles. These findings reflect associations observed in the early post-loss period rather than causal relationships. 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