Adverse childhood experiences and maternal anxiety and depression: a meta-analysis

Abstract

Background It has been proposed that adverse childhood experiences (ACEs) can put women at risk for mental illness in the pregnancy and postpartum periods. While some studies have found strong support for this proposition, others have found weak or no support. This study is a meta-analysis of the association between ACEs and maternal mental health to resolve between-study discrepancies, and to examine potential moderators of associations. Methods Three electronic databases (i.e., MEDLINE, Embase, and PsycINFO) were searched up to November 2018 by a health sciences librarian. A hand search was conducted in January 2020 and relevant studies were added. Included studies reported on associations between ACEs and maternal depression and/or anxiety in the perinatal period (pregnancy to 1-year postpartum). Pregnancy and postpartum outcomes were examined separately for both depression and anxiety. Random-effect meta-analyses were conducted. Moderator analyses were conducted using meta-regression. Study quality was evaluated using a 15-point scale. Results The initial search yielded 4646 non-duplicate records and full text review occurred for 196 articles. A total of 15 studies (N = 7788) were included in the meta-analyses, of which 2 were also described narratively. Publication year ranged from 1998 to 2019. Mothers were approximately 28.93 years of age when they retrospectively reported on their ACEs. All studies had maternal self-report questionnaires for the mental health outcomes. Study quality ranged from 7 to 12. The pooled effect sizes between ACEs and prenatal (N = 12; r = .19; 95% CI= .13, .24) and postpartum (N = 7; r = .23; 95% CI = .06 to .39) depressive symptoms were significant. The pooled effect size between ACEs and prenatal anxiety was also significant (N = 5; r = .14; 95% CI= .07, .21). Moderator analyses indicated that timing of depressive and anxiety symptoms may be important for understanding associations. Conclusions ACEs confer risk to maternal mental health, albeit effect sizes are small to moderate in magnitude. Trauma-informed approaches, as well as increased mental health support during and after pregnancy, may help to offset the relative risk of ACEs on maternal mental health.

Heart rate variability in late pregnancy: exploration of distinctive patterns in relation to maternal mental health

“…Each individual was also characterized as to whether they had an elevated number, above 5, of traumatic events in childhood (75th percentile). Childhood trauma was the focus given the association of maternal childhood trauma with perinatal mood and anxiety disorders 57 – 59 . The LITE has been studied in its ability to assess for exposure to childhood traumas so that the cumulative effects can be studied in relation to other factors and outcomes 60 .…”

Biopsychosocial Factors during the Perinatal Period: Risks, Preventative Factors, and Implications for Healthcare Professionals

“…Understanding the ACE exposure of a maternal population from a mental health perspective can also allow for a trauma informed approach to care. In a meta-analysis evaluating risk of anxiety and/or depression, Racine et al [23] describe a small to moderate impact on maternal mental health from ACEs. Routine screening for ACEs is recommended in order to properly assess risk for poor pregnancy outcomes [24].…”

Examining the Relationship Between Childhood Adverse Experiences and Postpartum Depression and Breastfeeding Self-Efficacy Using Structural Equation Modeling

“…Postpartum depresyon bebek sahibi olmakla birlikte sosyal, psikolojik ve hormonal değişikliklerle ilişkilendirildiği için (Mehta & Sheth, 2006), ÇÇOY'ın postpartum depresyonu arttırıcı bir etkisi olduğu düşünülmektedir (DSÖ, 2017). Üstelik deneyimlenen ÇÇOY sayısı arttıkça PPD şiddeti de artmaktadır (Perry ve ark., 2020;Racine 2021).…”