The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study

Abstract

Background Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results Associations between trauma and depressive symptoms differed by site ( =2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.

Intergenerational effects of violence on women’s perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam

“…The detrimental effect of p-IPV and childhood trauma then doubled the risk of poor maternal mental health and adverse birth outcomes. This is consistent with other research in South Africa [65]. The intergenerational effect of victimization is also consistent with studies that show women who have experienced multiple adverse events have more stress and trauma-related symptoms in the last trimester than women with low exposure [4] and a dose-response relationship was found between multiple incidents of abuse and the highest levels of psychological distress [66].…”

Violence and adversity among pregnant women and new mothers in central Vietnam

“…The detrimental effect of p-IPV and childhood trauma then doubled the risk of poor maternal mental health. This is consistent with other research in South Africa (Mal-Sarkar et al, 2021).…”

“…People who have been exposed to childhood violence are more likely to show antagonising behaviours later in life, making them more vulnerable to violent conflict (Widom & Wilson, 2015). Pregnancy is a critical stage where childhood maltreatment leads to re-victimisation that is, where violence is intergenerationally transmitted from a mother's life course to her unborn child (Mal-Sarkar et al, 2021;Roubinov et al, 2021). However, intergenerational transmission is also evident when victims of child maltreatment have an elevated risk of being victims of violence and abuse throughout their adult years (Liel et al, 2020).…”

Childhood adversity during the post‐apartheid transition and COVID‐19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis

“…Childhood adversity is a well‐known risk factor for a wide range of adult mental health symptoms in South Africa, including depression, substance use, and suicidal ideation (Bhengu et al, 2020; Hatcher et al, 2019; Orri et al, 2022). While the pathways underlying the adult mental health effects of childhood adversity in South Africa are still being identified, researchers have suggested that poor emotional, familial, household, and socioeconomic conditions likely influence and sustain the poor psychological effects of childhood adversity across the lifecourse (Hatcher et al, 2019; Jones et al, 2018; Mal‐Sarkar et al, 2021). Our findings also contribute to a limited literature on the early life origins of adult PTSD risk in low‐ and middle‐income contexts (Choi et al, 2015; McLaughlin et al, 2017), which points to similar adverse effects of childhood adversity on adult PTSD symptoms (Geng et al 2021; Norris et al, 2003).…”