Department of Psychiatry and Behavioral Sciences, San Francisco (UCSF), Weill Institute for Neurosciences, University of California, Box 0110, 550 16th Street, CA, 94143, San Francisco, USA.
Department of Pediatrics, UCSF, San Francisco, CA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2023 Nov;58(11):1625-1636. doi: 10.1007/s00127-022-02401-z. Epub 2023 Feb 3.
Despite growing recognition that unfortunately common maternal stress exposures in childhood and pregnancy may have intergenerational impacts on children's psychiatric health, studies rarely take a life course approach. With child psychopathology on the rise, the identification of modifiable risk factors is needed to promote maternal and child well-being. In this study, we examined associations of maternal exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE) with child mental health problems in a large, sociodemographically diverse sample.
Participants were mother-child dyads in the ECHO-PATHWAYS consortium's harmonized data across three U.S. pregnancy cohorts. Women completed questionnaires regarding their own exposure to CTE and PSLE, and their 4-6-year-old child's mental health problems using the Child Behavior Checklist (CBCL). Regression analyses estimated associations between stressors and child total behavior problems, adjusting for confounders.
Among 1948 dyads (child age M = 5.13 (SD = 1.02) years; 38% Black, 44% White; 8.5% Hispanic), maternal history of CTE and PSLE were independently associated with children's psychopathology: higher CTE and PSLE counts were related to higher total problems ([ß = 0.11, 95% CI [.06, .16]; ß = 0.21, 95% CI [.14, 0.27]) and greater odds of clinical levels of problems (OR = 1.41; 95% CI [1.12, 1.78]; OR = 1.36; 95% CI [1.23, 1.51]). Tests of interaction showed PSLEs were more strongly associated with child problems for each additional CTE experienced.
Findings confirm that maternal exposure to CTE and PSLE are independently associated with child mental health, and history of CTE exacerbates the risk associated with PSLE, highlighting intergenerational risk pathways for early psychopathology. Given the prevalence of these exposures, prevention and intervention programs that reduce childhood trauma and stress during pregnancy will likely positively impact women's and their children's health.
尽管越来越多的人认识到，不幸的是，儿童期和孕期常见的母体应激暴露可能会对儿童的精神健康产生代际影响，但研究很少采用生命历程方法。随着儿童精神病理学的上升，需要确定可改变的风险因素，以促进母婴健康。在这项研究中，我们在一个大型的、社会人口统计学多样化的样本中，研究了母亲暴露于儿童期创伤事件（CTE）和孕期应激性生活事件（PSLE）与儿童心理健康问题之间的关系。
参与者是 ECHO-PATHWAYS 联盟三个美国妊娠队列的母子对。女性使用儿童行为检查表（CBCL）完成了关于自己暴露于 CTE 和 PSLE 以及 4-6 岁儿童心理健康问题的问卷。回归分析估计了应激源与儿童总体行为问题之间的关联，调整了混杂因素。
在 1948 对母子对中（儿童年龄 M=5.13（SD=1.02）岁；38%为黑人，44%为白人；8.5%为西班牙裔），母体 CTE 和 PSLE 史与儿童精神病理学独立相关：较高的 CTE 和 PSLE 计数与较高的总体问题相关（[β=0.11，95%CI [0.06，0.16]；β=0.21，95%CI [0.14，0.27]）和更高的临床问题发生率（OR=1.41；95%CI [1.12，1.78]；OR=1.36；95%CI [1.23，1.51]）。交互作用检验表明，对于每增加一次 CTE 暴露，PSLE 与儿童问题的关联更强。
研究结果证实，母亲暴露于 CTE 和 PSLE 与儿童心理健康独立相关，而 CTE 史加剧了与 PSLE 相关的风险，突出了早期精神病理学的代际风险途径。鉴于这些暴露的普遍性，减少儿童期创伤和孕期压力的预防和干预计划可能会对妇女及其儿童的健康产生积极影响。
