Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Ann Epidemiol. 2020 Dec;52:26-34. doi: 10.1016/j.annepidem.2020.09.015. Epub 2020 Oct 1.
The purpose of this study was to examine how combinations of adverse childhood events (ACEs) contribute to the risk of postpartum depression and the mediating role of prenatal social support.
The Adverse Childhood Experiences Scale Questionnaire and the Edinburgh Postnatal Depression Scale Questionnaire were used to measure the study's exposure and outcome. Among a cohort of 419 mothers enrolled in a home visiting (HV) program, latent class analyses were used to identify classes of ACEs exposure. General linear models assessed the risk of postpartum depression, and prenatal social support was examined as a mediator.
Four distinct classes of ACE exposure were identified. On the Edinburgh Postnatal Depression scale, mothers who were classified in Classes 1-3 scored higher by 2.6-4.4 points compared with women in Class 0. ACE class was found to be indirectly associated with postpartum depression scores through prenatal social support.
Identifying combinations of ACEs in an HV program has the potential to improve the characterization of ACEs among low-income perinatal women in the United States. Elucidating how these combinations contribute to the risk of postpartum depression has the potential to identify women at increased risk, which can help HV programs prioritize prevention efforts.
本研究旨在探讨多种不良童年经历（ACEs）如何增加产后抑郁的风险，以及产前社会支持的中介作用。
采用不良童年经历量表问卷和爱丁堡产后抑郁量表问卷来衡量研究的暴露和结果。在一项参与家庭访视（HV）项目的 419 名母亲队列中，采用潜在类别分析来识别 ACE 暴露的类别。采用一般线性模型评估产后抑郁的风险，并检验产前社会支持的中介作用。
确定了 4 种不同的 ACE 暴露类别。在爱丁堡产后抑郁量表上，与 Class 0 的女性相比，被归类为 Class 1-3 的母亲得分高出 2.6-4.4 分。ACE 类别通过产前社会支持与产后抑郁评分呈间接相关。
在 HV 项目中识别 ACE 的组合有可能改善美国低收入围产期妇女中 ACE 的特征描述。阐明这些组合如何增加产后抑郁的风险有可能确定处于高风险的妇女，这有助于 HV 项目优先开展预防工作。
