Adverse Childhood Experiences and Changing Levels of Psychosocial Distress Scores across Pregnancy in Kenyan Women

Abstract

Background: Adverse childhood experiences (ACEs) have been associated with deleterious effects on mental health in pregnancy. Methods: The ACE International Questionnaire (ACE-IQ) was used to measure neglect, abuse, and household dysfunction. Longitudinal mixed effect modelling was used to test the effect of ACEs on pregnancy-related anxiety, depressive symptoms, and perceived stress at two time points (12–19 and 22–29 weeks) during pregnancy. Results: A total of 215 women who were predominantly married (81%) and had attained tertiary education (96%) were enrolled. Total ACEs were significantly associated with depressive symptoms (r = 0.23, p < 0.05) and perceived stress (r = 0.18, p < 0.05). As depressive symptoms decreased, t (167) = −8.44, p < 0.001, perceived stress increased, t (167) = 4.60, p < 0.001, and pregnancy-related anxiety remained unchanged as pregnancy progressed. Contact sexual abuse (p < 0.01) and parental death or divorce (p = 0.01) were significantly associated with depression over time (p < 0.01). Total ACEs in this study were associated with depressive symptoms early but not late in pregnancy. Conclusions: Higher total ACEs were positively associated with depressive symptoms and perceived stress during pregnancy, suggesting that mental disorders may have an impact on pregnancy outcomes and ought to be addressed. Further validation of the Edinburgh Postnatal Depression Scale (EPDS) tool in local settings is required.

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

“…Our findings are consistent with findings from both a low- and middle-income country (Kenya) [ 32 ] and a high-income country (USA) which showed an association between ACEs and depression/anxiety and perceived stress [ 33 , 34 ]. Women who endorsed that their own parents/guardians did not understand their childhood problems and worries also had slightly higher odds of comorbidity than those who endorsed that their parents/guardian understood their problems and worries.…”

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

“…Our findings are consistent with findings from both a low- and middle-income country (Kenya) [ 32 ] and a high-income country (USA) which showed an association between ACEs and depression/anxiety and perceived stress [ 33 , 34 ]. Women who endorsed that their own parents/guardians did not understand their childhood problems and worries also had slightly higher odds of comorbidity than those who endorsed that their parents/guardian understood their problems and worries.…”

Associations Between Adverse Childhood Experiences and Stressful Life Events and Health Outcomes in Pregnant and Breastfeeding Women from Diverse Racial and Ethnic Groups

“…When examining psychological measures, both ACEs and SLEs appeared to independently increase the risk of severe mental health concerns and anxiety during pregnancy in this group, with more associations among SLEs and mental health outcomes. This supports previous research in these areas 12,21 –23 and expands the literature by specifically examining a diverse sample. It is also of note that SLE scores had more significant findings than ACEs in our sample, but previous research on SLEs alone demonstrate their relationship with mental health outcomes in racially/ethnically diverse groups.…”

Prevalence of Adverse Childhood Experiences in Oman

“…The study's ndings indicated that ACEs were highly prevalent and that individuals with a history of ACEs demonstrated signi cantly elevated odds ratios for experiencing adverse health outcomes in adulthood (Felitti et al, 1998). Since then, this study has been replicated many times around the world with comparable results (Bellis et al, 2019;Petruccelli et al, 2019;Samia et al, 2020;Subramaniam et al, 2020;Thomas et al, 2020). The likelihood of any health, mental health, or behavioral outcome increases as the number of ACEs increases, indicating the synergistic effects of ACEs.…”

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

“…Our findings are consistent with findings from both a low- and middle-income country (Kenya) [ 32 ] and a high-income country (USA) which showed an association between ACEs and depression/anxiety and perceived stress [ 33 , 34 ]. Women who endorsed that their own parents/guardians did not understand their childhood problems and worries also had slightly higher odds of comorbidity than those who endorsed that their parents/guardian understood their problems and worries.…”

Associations Between Adverse Childhood Experiences and Stressful Life Events and Health Outcomes in Pregnant and Breastfeeding Women from Diverse Racial and Ethnic Groups

“…When examining psychological measures, both ACEs and SLEs appeared to independently increase the risk of severe mental health concerns and anxiety during pregnancy in this group, with more associations among SLEs and mental health outcomes. This supports previous research in these areas 12,21 –23 and expands the literature by specifically examining a diverse sample. It is also of note that SLE scores had more significant findings than ACEs in our sample, but previous research on SLEs alone demonstrate their relationship with mental health outcomes in racially/ethnically diverse groups.…”

Prevalence of Adverse Childhood Experiences in Oman

“…The study's ndings indicated that ACEs were highly prevalent and that individuals with a history of ACEs demonstrated signi cantly elevated odds ratios for experiencing adverse health outcomes in adulthood (Felitti et al, 1998). Since then, this study has been replicated many times around the world with comparable results (Bellis et al, 2019;Petruccelli et al, 2019;Samia et al, 2020;Subramaniam et al, 2020;Thomas et al, 2020). The likelihood of any health, mental health, or behavioral outcome increases as the number of ACEs increases, indicating the synergistic effects of ACEs.…”

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

“…Our findings are consistent with findings from both a low- and middle-income country (Kenya) [ 32 ] and a high-income country (USA) which showed an association between ACEs and depression/anxiety and perceived stress [ 33 , 34 ]. Women who endorsed that their own parents/guardians did not understand their childhood problems and worries also had slightly higher odds of comorbidity than those who endorsed that their parents/guardian understood their problems and worries.…”

Associations Between Adverse Childhood Experiences and Stressful Life Events and Health Outcomes in Pregnant and Breastfeeding Women from Diverse Racial and Ethnic Groups

“…When examining psychological measures, both ACEs and SLEs appeared to independently increase the risk of severe mental health concerns and anxiety during pregnancy in this group, with more associations among SLEs and mental health outcomes. This supports previous research in these areas 12,21 –23 and expands the literature by specifically examining a diverse sample. It is also of note that SLE scores had more significant findings than ACEs in our sample, but previous research on SLEs alone demonstrate their relationship with mental health outcomes in racially/ethnically diverse groups.…”

Prevalence of Adverse Childhood Experiences in Oman

“…The study's ndings indicated that ACEs were highly prevalent and that individuals with a history of ACEs demonstrated signi cantly elevated odds ratios for experiencing adverse health outcomes in adulthood (Felitti et al, 1998). Since then, this study has been replicated many times around the world with comparable results (Bellis et al, 2019;Petruccelli et al, 2019;Samia et al, 2020;Subramaniam et al, 2020;Thomas et al, 2020). The likelihood of any health, mental health, or behavioral outcome increases as the number of ACEs increases, indicating the synergistic effects of ACEs.…”