Category: Maternal Fetal Medicine
Introduction: A moderate association exists between maternal history of adverse childhood experiences (ACEs) and risk of prenatal depression. However, this association has not been examined with regards to changes in depression across the perinatal period, nor has the relative strength of this association been compared to other important psycho-social determinants of women’s health. The objectives of this longitudinal study were to: (1) determine whether ACEs predict depressive symptomology in pregnancy and the postpartum period; (2) test the relative contribution of ACEs, with other established risks of depression, including social support.
Methods: Data from 1,994 women were collected from a prospective pregnancy cohort. Women completed questionnaires related to ACEs prior to the age of 18. In pregnancy and at 4 months postpartum, social support was measured using the Medical Outcomes Study Social Support Survey and clinical cut-off scores for depression were assessed using the Edinburgh Postnatal Depression Scale.
Results: (1) Logistic regression demonstrated that after accounting for sociodemographic factors and social support, ACEs predicted depression in pregnancy (AOR=1.26, CI=1.12-1.43), postpartum (AOR=1.34, CI=1.17-1.52), and across the perinatal period (AOR=1.31, CI=1.12-1.54). (2) Logistic regression demonstrated that after accounting for sociodemographic factors and ACEs, social support predicted depression in pregnancy (AOR=3.38, CI=2.28-5.0), postpartum (AOR=2.85, CI=1.81-4.47), and across the perinatal period (AOR=2.40, CI=1.40-4.11) at a magnitude larger than that observed between ACEs and depression.
Conclusion: ACEs and low social support are both risk factors for depression, however low social support predicted the highest odds of depression. These results indicate the importance of asking about social support to women who are pregnant and in the postpartum period.
Hannah Byles– Medical Student, University of Calgary
Nicole Racine– Post-Doctoral Fellow, University of Calgary
Sheila McDonald– Co-Investigator, Alberta Health Services, University of Calgary
Suzanne Tough– Professor, Department of Paediatrics, University of Calgary, Calgary, AB
Sheri Madigan– Professor, University of Calgary