Purpose: The primary aim was to examine the relationship between maternal childhood adversity and prenatal levels of stress, depression, and proinflammatory cytokines; and, secondly, to explore the relationship of these variables with neonatal birth outcomes.
Significance/Rationale: Increased proinflammatory cytokines during pregnancy are linked to maternal depressive risk and poor birth outcomes. Maternal exposure to childhood adversity and poverty may intensify each of these, predisposing to health disparity in birth outcomes.
Methods/Analysis: During their second (16-24 weeks gestation) and third trimester (28-32 weeks) of pregnancy, women (N=64), 18-39 years old, provided a blood sample to measure the proinflammatory cytokine, TNF-alpha; and completed instruments measuring childhood adversity (Child Trauma Questionnaire), perceived stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies-Depression and Edinburgh Depression Scale) and social support (Social Provisions Scale). Childhood adversity assessed: emotional neglect/abuse, physical neglect/abuse and sexual abuse. Poverty was determined by current household income and number in the household per federal guidelines. Correlations among variables were evaluated and moderation analysis explored interaction effects.
Results: Nearly 25% of the sample reported exposure to childhood adversity, and women with greater childhood adversity had increased perceived stress and increased depressive symptoms. Also, women reporting greater depressive symptoms had higher plasma TNF-alpha levels. Moderation analysis revealed that women exposed to childhood adversity, together with current household poverty, had higher levels of TNF-alpha. Evaluation of relationships with birth outcomes revealed that women with greater childhood adversity and higher TNF-alpha delivered lower birth weight infants. Also, exposure to childhood adversity was associated with lower infant gestational age; however, higher levels of social support moderated (attenuated) this relationship.
Conclusion:Maternal childhood adversity associates with greater psychological morbidity during pregnancy and poorer neonatal outcomes.
Implications. Findings emphasize the need for prenatal psychosocial screening to include assessment of childhood adversity and the encouragement of social support to buffer negative effects of childhood adversity on birth outcomes.
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