Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta, T2N 1N4, Canada.
Division of Gastroenterology, University of Alberta, Edmonton, Canada.
Arch Womens Ment Health. 2020 Apr;23(2):169-180. doi: 10.1007/s00737-019-00966-4. Epub 2019 Apr 23.
Adverse childhood experiences (ACEs) have been found to be associated with various health conditions; however, there is dearth of evidence on the relationship between ACEs and prenatal depression. This study was conducted to determine the association between overall ACE score and prenatal depression symptoms, assess the moderating effect of social support and partner support on this relationship, and determine the association between individual ACE scores and prenatal depression. A secondary analysis was conducted of data from an RCT that assessed the feasibility of e-screening for maternal mental health among 636 pregnant women recruited from antenatal clinics. Two logistic regression models were built to reach our objectives. Over 80% of the participants were older than 25 years and had education beyond high school. Eighteen percent of the women had an ACE score of four or more. Univariable analysis found a 2.5-fold increase in the odds of prenatal depression for women with an ACEs score of ≥ 4. When examining the overall ACE score, lack of social support during pregnancy [AOR = 4.16; 95%CI (2.10-10.35)] and partner's relationship [AOR = 2.23; 95%CI (1.12-4.44)] were associated with prenatal depression while among the individual ACE scores, living with a person who went to prison was found to be associated with prenatal depression even when controlled for all variables. No moderating effect was found. These findings suggest for the improvement of partner's relationship and provision of social support before women conceive, in order to mitigate the effect of these adversities.
不良的童年经历(ACEs)与各种健康状况有关;然而,关于 ACEs 与产前抑郁之间的关系,证据不足。本研究旨在确定总体 ACE 评分与产前抑郁症状之间的关联,评估社会支持和伴侣支持对这种关系的调节作用,并确定个体 ACE 评分与产前抑郁之间的关系。对一项评估电子筛查孕妇心理健康可行性的 RCT 的数据进行了二次分析,该 RCT 招募了 636 名来自产前诊所的孕妇。建立了两个逻辑回归模型来达到我们的目标。超过 80%的参与者年龄在 25 岁以上,受过高中以上教育。18%的女性 ACE 评分为 4 分或以上。单变量分析发现,ACE 评分为≥4 的女性产前抑郁的几率增加了 2.5 倍。当检查总体 ACE 评分时,怀孕期间缺乏社会支持[OR=4.16;95%CI(2.10-10.35)]和伴侣关系[OR=2.23;95%CI(1.12-4.44)]与产前抑郁有关,而在个体 ACE 评分中,与服刑人员同住被发现与产前抑郁有关,即使在控制了所有变量的情况下也是如此。未发现调节作用。这些发现表明,为了减轻这些逆境的影响,应在女性怀孕前改善伴侣关系并提供社会支持。