Association of Adverse Childhood Experiences and Resilience With Depression and Anxiety During Pregnancy. 2024

Carey R Watson, and Abigail Eaton, and Cynthia I Campbell, and Stacey E Alexeeff, and Lyndsay A Avalos, and Kathryn K Ridout, and Kelly C Young-Wolff
Obstetrics and Gynecology, Kaiser Permanente, Antioch Medical Center, Antioch, the Division of Research, Kaiser Permanente Northern California, Oakland, the Department of Psychiatry, Kaiser Permanente, Santa Rosa Medical Center, Santa Rosa, and the Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California.

This was a retrospective cohort study of pregnant individuals in the Kaiser Permanente Northern California system who were screened for adverse childhood experiences and resilience as part of standard prenatal care at about 16 weeks of gestation. Overall, 14,625 pregnancies were included; 17.0% had newly identified depression; 9.8% had newly identified depression symptoms; and 8.9% had newly identified anxiety during the pregnancy with no known preexisting diagnosis. We found that adverse childhood experiences and low resilience were independently associated with newly identified depressive disorders, depression symptoms, and anxiety disorders during pregnancy. When adverse childhood experiences and resilience were modeled in combination, the greatest odds of each outcome occurred in individuals with a combination of four or more adverse childhood experiences and low resilience (vs no adverse childhood experiences and high resilience): depression adjusted odds ratio (aOR) 6.43 (95% CI, 5.23-7.90), depression symptoms aOR 9.49 (95% CI, 7.50-12.0), and anxiety disorder aOR 4.79 (95% CI, 3.81-6.02). Routine screening for adverse childhood experiences and resilience may identify individuals at risk of developing prenatal depression and anxiety, allowing faster resource linkage and potentially improved maternal and child outcomes.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000076783 Adverse Childhood Experiences Deleterious experiences in first 18 years of life. Adolescent Trauma,Childhood Trauma,Early Life Stress,Early-Life Stress,Traumatic Childhood Experiences,Adolescent Traumas,Adverse Childhood Experience,Childhood Experience, Adverse,Childhood Experience, Traumatic,Childhood Experiences, Adverse,Childhood Experiences, Traumatic,Childhood Traumas,Early Life Stresses,Early-Life Stresses,Experience, Traumatic Childhood,Experiences, Traumatic Childhood,Life Stress, Early,Life Stresses, Early,Stress, Early Life,Stress, Early-Life,Stresses, Early Life,Stresses, Early-Life,Trauma, Adolescent,Trauma, Childhood,Traumas, Adolescent,Traumas, Childhood,Traumatic Childhood Experience
D001007 Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS. Angst,Anxiousness,Hypervigilance,Nervousness,Social Anxiety,Anxieties, Social,Anxiety, Social,Social Anxieties
D001008 Anxiety Disorders Persistent and disabling ANXIETY. Anxiety Neuroses,Anxiety States, Neurotic,Neuroses, Anxiety,Anxiety Disorder,Anxiety State, Neurotic,Disorder, Anxiety,Disorders, Anxiety,Neurotic Anxiety State,Neurotic Anxiety States,State, Neurotic Anxiety,States, Neurotic Anxiety
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D055500 Resilience, Psychological The human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Psychological Resilient Responses,Resilience,Resiliency,Resiliency, Psychological,Resilient Responses, Psychological,Stress Immunity,Immunity, Stress,Psychological Resilience,Psychological Resiliency,Psychological Resilient Response,Resiliences,Resiliencies,Resilient Response, Psychological,Response, Psychological Resilient,Stress Immunities

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