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J Womens Health (Larchmt). 2019 Apr;28(4):452-461. doi: 10.1089/jwh.2018.7108. Epub 2018 Sep 5.

Adverse Childhood Experiences and Mental and Behavioral Health Conditions During Pregnancy: The Role of Resilience.

Author information

1
1 Division of Research, Kaiser Permanente Northern California, Oakland, California.
2
2 Family Violence Prevention Program, Kaiser Permanente Northern California, Oakland, California.
3
3 Obstetrics and Gynecology, Kaiser Antioch Medical Center, Antioch, California.
4
4 Department of Psychiatry, Kaiser Permanente San Jose, San Jose, California.
5
5 The Permanente Medical Group, Regional Offices, Kaiser Permanente Northern California, Oakland, California.

Abstract

INTRODUCTION:

Little is known about how exposure to adverse childhood experiences (ACEs) and protective factors, such as resilience, influence prenatal mental and behavioral health. This study examined associations between exposure to ACEs and mental and behavioral health during pregnancy overall and among women with high versus low levels of resilience.

MATERIALS AND METHODS:

Women in two Kaiser Permanente Northern California medical centers were screened for ACEs and resilience during prenatal care (∼14-23 weeks of gestation; N = 355). Multivariable logistic regression analyses examined associations between ACEs and prenatal mental and behavioral health conditions overall and for women with low (≤32) versus high (>32) resilience on the 10-item Connor-Davidson Resilience Scale.

RESULTS:

Overall, 54% of women reported 0 ACEs, 28% 1-2 ACEs, and 18% 3+ ACEs. Relative to women with 0 ACEs, those with 1-2 ACEs had higher odds of an anxiety or depressive disorder and intimate partner violence (IPV) (odds ratios [ORs] 2.42-3.12, p < 0.05), and those with 3+ ACEs had higher odds of an anxiety or depressive disorder, depression symptoms, and IPV (ORs 3.08-4.71, p < 0.05). In stratified analyses by high (56%) and low (44%) resilience, having one or more ACEs (vs. 0 ACEs) was only associated with worse mental and behavioral health in women with low resilience.

CONCLUSIONS:

ACEs predicted mental and behavioral health conditions among pregnant women, and associations were the strongest among women with low levels of current resilience. Longitudinal research is needed to understand the causal mechanisms underlying these associations.

KEYWORDS:

adverse childhood experiences; intimate partner violence; mental health; pregnancy; resilience

PMID:
30183473
PMCID:
PMC6482914
[Available on 2020-04-01]
DOI:
10.1089/jwh.2018.7108

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