Garofalo Luciano, Booth-LaForce Cathryn, Nurius Paula, Thompson Stephanie, Calhoun Becca, Shimomaeda Lisa, Lengua Liliana
University of Washington, Department of Child, Family, and Population Health Nursing, United States.
University of Washington, School of Social Work, United States.
J Affect Disord Rep. 2023 Dec;14. doi: 10.1016/j.jadr.2023.100621. Epub 2023 Jun 28.
Socioeconomic adversity can negatively impact the mental and physical health of mothers and their offspring. This paper extends understanding of the interrelationship of these factors during the perinatal time frame, specifically to: 1.) evaluate the impact of adverse childhood events (ACES), negative life events (NLEs), and socioeconomic factors on the mental health of low-income expecting mothers; 2) evaluate for differences by race/ethnicity in adversity predicting perinatal mental health; 3) examine how mindfulness interacts with socioeconomic adversity in predicting prenatal mental health.
202 predominately non-white primiparous females with household income at or below 200% of the federal poverty level participated. Measures included ACEs, NLEs, and several descriptors of socioeconomic status. Resilience and mindfulness were measured as possible protective factors. In the sequence of socioeconomic factors, ACEs, and NLEs, hierarchical multiple regression tested these measures as predictors of prenatal depression and anxiety, also evaluating for interaction effects.
Controlling for socioeconomic factors, higher ACEs and NLEs independently predicted worse prenatal mental health. Cumulative socioeconomic risk interacted with ACEs to predict higher prenatal anxiety and more accurately predict prenatal depression scores. Higher mindfulness predicted lower anxiety and depression regardless of adversity, but was also significantly negatively correlated with ACEs.
Generalizability of results are limited by the sample size and specific geographic region. Conclusion: Socioeconomic and psychosocial adversity cumulatively impact prenatal mental health. Mindfulness may be a valuable target for resilience-enhancing interventions prepartum but is not a solution to the clear detriments that social and economic marginalization have on mental health.
社会经济逆境会对母亲及其后代的身心健康产生负面影响。本文拓展了对围产期这些因素之间相互关系的理解，具体如下：1.）评估童年不良经历（ACES）、负面生活事件（NLEs）和社会经济因素对低收入准妈妈心理健康的影响；2）评估在预测围产期心理健康方面，不同种族/族裔在逆境方面的差异；3）研究正念在预测产前心理健康时如何与社会经济逆境相互作用。
202名主要为非白人的初产妇参与了研究，其家庭收入处于或低于联邦贫困线的200%。测量指标包括童年不良经历、负面生活事件以及社会经济地位的几个描述指标。复原力和正念被作为可能的保护因素进行测量。在社会经济因素、童年不良经历和负面生活事件的序列中，分层多元回归检验了这些指标作为产前抑郁和焦虑预测因素的作用，同时也评估了交互效应。
在控制社会经济因素后，较高的童年不良经历和负面生活事件独立预测了更差的产前心理健康。累积社会经济风险与童年不良经历相互作用，预测了更高的产前焦虑，并更准确地预测了产前抑郁得分。较高的正念水平无论在何种逆境下都预测了较低的焦虑和抑郁，但也与童年不良经历显著负相关。
结果的普遍性受到样本量和特定地理区域的限制。结论：社会经济和心理社会逆境会累积影响产前心理健康。正念可能是产前增强复原力干预的一个有价值的目标，但并不能解决社会和经济边缘化对心理健康造成的明显损害。
