Nichole Nidey1, Katherine Bowers2, Robert T Ammerman3, Anita N Shah4, Kieran J Phelan5, Margaret J Clark6, Judith B Van Ginkel6, Alonzo T Folger7. 1. 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. 2. Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 3. Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH. 4. Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 5. The Permanente Medical Group, Kaiser Permanente Pediatrics, San Rafael, CA. 6. Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH. 7. Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH. Electronic address: alonzo.folger@cchmc.org.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Alonzo T Folger; Karen T Putnam; Frank W Putnam; James L Peugh; Emily A Eismann; Ting Sa; Robert A Shapiro; Judith B Van Ginkel; Robert T Ammerman Journal: Paediatr Perinat Epidemiol Date: 2017-01-31 Impact factor: 3.980