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

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.