The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study
Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationshi...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | SSM: Population Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827321000458 |
| _version_ | 1819097990168576000 |
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| author | Tatini Mal-Sarkar Katherine Keyes Nastassja Koen Whitney Barnett Landon Myer Caroline Rutherford Heather J. Zar Dan J. Stein Crick Lund |
| author_facet | Tatini Mal-Sarkar Katherine Keyes Nastassja Koen Whitney Barnett Landon Myer Caroline Rutherford Heather J. Zar Dan J. Stein Crick Lund |
| author_sort | Tatini Mal-Sarkar |
| collection | DOAJ |
| description | Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results: Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes. |
| first_indexed | 2024-12-22T00:23:52Z |
| format | Article |
| id | doaj.art-20fd1d141edf44318f51c6141a9bb6fd |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-12-22T00:23:52Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-20fd1d141edf44318f51c6141a9bb6fd2022-12-21T18:45:06ZengElsevierSSM: Population Health2352-82732021-06-0114100770The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort studyTatini Mal-Sarkar0Katherine Keyes1Nastassja Koen2Whitney Barnett3Landon Myer4Caroline Rutherford5Heather J. Zar6Dan J. Stein7Crick Lund8Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States; Corresponding author. Columbia University New York, NY, 10032, United States.Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United StatesDepartment of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South AfricaDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South AfricaDivision of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United StatesDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South AfricaDepartment of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South AfricaAlan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa; King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 18 de Crespigny Park, London, SE5 8AF, United KingdomBackground: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results: Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.http://www.sciencedirect.com/science/article/pii/S2352827321000458DepressionTraumaPovertyEpidemiologyBirth cohort |
| spellingShingle | Tatini Mal-Sarkar Katherine Keyes Nastassja Koen Whitney Barnett Landon Myer Caroline Rutherford Heather J. Zar Dan J. Stein Crick Lund The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study SSM: Population Health Depression Trauma Poverty Epidemiology Birth cohort |
| title | The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study |
| title_full | The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study |
| title_fullStr | The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study |
| title_full_unstemmed | The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study |
| title_short | The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study |
| title_sort | relationship between childhood trauma socioeconomic status and maternal depression among pregnant women in a south african birth cohort study |
| topic | Depression Trauma Poverty Epidemiology Birth cohort |
| url | http://www.sciencedirect.com/science/article/pii/S2352827321000458 |
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